Marysville Smile Center LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MARYSVILLE SMILE CENTER LLC

Practice address

1601 10TH St
Marysville, WA 98270-4631

Phone

(253) 212-3430

NPI assigned

Feb 28, 2019

Organization subpart

No

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

Authorized official

Name

Nari Lee

Title

Assistant Manager

Phone

(253) 212-3430

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551312000000",
    "number": "1447717152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3670 BRIDGEPORT WAY W UNIT B",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664413",
            "telephone_number": "253-212-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 10TH ST",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704631",
            "telephone_number": "253-212-3430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYSVILLE SMILE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-28",
        "last_updated": "2019-02-28",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "NARI",
        "authorized_official_title_or_position": "ASSISTANT MANAGER",
        "authorized_official_telephone_number": "253-212-3430"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.