NPIMap

Organization Active NPI

Southwestern Smile Design, LLC

Doing business as Mountain View Dentistry

  • Dental Clinic/Center
  • Surprise, AZ
National Provider Identifier
1437394731
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D7229 Issued in AZ
Legal business name
SOUTHWESTERN SMILE DESIGN, LLC
Doing business as
Mountain View Dentistry
Practice address
18775 N Reems Rd
C-300
Surprise, AZ 85374-8647
Phone
(623) 584-3965
Fax
(623) 584-0130
NPI assigned
Dec 16, 2008
Last updated
Dec 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mitchell Ward Ellingson, D.D.S.NPI 1497956742
Title
Owner/Dentist
Phone
(623) 377-6185

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D7229 AZ Primary

Addresses

Primary practice location

18775 N Reems Rd
C-300
Surprise, AZ 85374-8647

Mailing address

18775 N Reems Rd
C-300
Surprise, AZ 85374-8647
Phone (623) 584-3965

Other names 1

  • Mountain View Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

18775 N Reems Rd
#C300
Surprise, AZ 85374
Phone (623) 584-3965

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229385600000",
    "number": "1437394731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18775 N REEMS RD",
            "address_2": "C-300",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853748647",
            "telephone_number": "623-584-3965",
            "fax_number": "623-584-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18775 N REEMS RD",
            "address_2": "C-300",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853748647",
            "telephone_number": "623-584-3965",
            "fax_number": "623-584-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN SMILE DESIGN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-16",
        "last_updated": "2008-12-16",
        "status": "A",
        "authorized_official_last_name": "ELLINGSON",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "WARD",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "623-377-6185",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "D7229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain View Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.