NPIMap

Organization Active NPI

Jie Su, DMD, P.a.

Doing business as A Smile Pediatric Dentistry

  • Pediatric Dentistry
  • Plano, TX
National Provider Identifier
1437429529
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
23596 Issued in TX
Legal business name
JIE SU, DMD, P.A.
Doing business as
A Smile Pediatric Dentistry
Practice address
4500 Legacy Dr
Suite 300
Plano, TX 75024-2179
Phone
(972) 618-2958
NPI assigned
Jan 5, 2012
Last updated
Mar 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Authorized official

Name
Dr. Jie Su, DMDNPI 1891995783
Title
President
Phone
(972) 618-2958

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 23596 TX Primary

Addresses

Primary practice location

4500 Legacy Dr
Suite 300
Plano, TX 75024-2179

Mailing address

4500 Legacy Dr
Suite 300
Plano, TX 75024-2179
Phone (972) 618-2958

Other names 1

  • A Smile Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

4500 Legacy Dr
Ste 300
Plano, TX 75024
Phone (972) 618-2958

Practitioners & affiliated clinicians

Practitioners 2

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": "1325721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489708800000",
    "number": "1437429529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 LEGACY DR",
            "address_2": "SUITE 300",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242179",
            "telephone_number": "972-618-2958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 LEGACY DR",
            "address_2": "SUITE 300",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242179",
            "telephone_number": "972-618-2958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIE SU, DMD, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-05",
        "last_updated": "2017-03-17",
        "status": "A",
        "authorized_official_last_name": "SU",
        "authorized_official_first_name": "JIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-618-2958",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "23596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Smile Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; 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.