Smileshack Missouri, LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

SMILESHACK MISSOURI, LLC

Doing business as

SmileShack

Practice address

9105 E 350
Raytown, MO 64133-5718

Phone

(816) 533-6819

NPI assigned

Dec 29, 2021

Organization subpart

No

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

Authorized official

Name

James Ballou, DDSNPI 1083942627

Title

Owner

Phone

(972) 672-9279

Specialties & licenses 1

Addresses

Other names 1

• SmileShack Doing business as

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Ian Ballou, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lewisville, TX
  • NPI 1083942627
  NPD Authorized official

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640736000000",
    "number": "1437819646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9105 E 350",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641335718",
            "telephone_number": "816-533-6819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9105 E 350",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641335718",
            "telephone_number": "816-533-6819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILESHACK MISSOURI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A",
        "authorized_official_last_name": "BALLOU",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-672-9279",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@smileshackdental.com",
            "affiliation": "N",
            "endpointDescription": "E-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9105 E 350",
            "city": "Raytown",
            "state": "MO",
            "country_code": "US",
            "postal_code": "641335718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SmileShack",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christina Simms, COUNSELOR
• Madeline Grace Sloan, DDS
• Karie Slupianek, COTA/L
• Smile Care Raytown, LLC
• Smile Safari of Missouri
• Aaron Nelson Smith, RD
• Charles P Smith, R.N.
• Gary L. Smith, D.D.S.
• Lashae Smith, BSW MSW LMSW
• Caroline Song, MA, PLPC

• Orthodontics and Dentofacial Orthopedics Dentistry in Raytown, MO
• Providers in Raytown, MO by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.