St John Smiles PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ST JOHN SMILES PC

Practice address

9486 Wicker Ave
Saint John, IN 46373-9400

Phone

(219) 232-8956

NPI assigned

Aug 27, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Abhishek Nagaraj

Title

Co-Owner

Phone

(219) 232-8956

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1477220267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13247 S BALTIMORE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606331431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9486 WICKER AVE",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463739400",
            "telephone_number": "219-232-8956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHN SMILES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "NAGARAJ",
        "authorized_official_first_name": "ABHISHEK",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "219-232-8956",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Google",
            "affiliation": "N",
            "address_1": "9486 Wicker Ave",
            "city": "Saint John",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463739400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Smile Solutions Inc
• Latrese Smith-Wynn, PT, DPT
• Kyerra Smith, MA, BCBA
• South Shore Smiles LLC
• St George Rehabilitation Services LLC
• St Margaret Mercy Healthcare Centers (St John Family Services)
• St Mena Therapy P.C.
• St. John Premier Dental
• Katherine Stalbaum, MD
• Michelle Sweeney Stan, LCSW

• Dentist in Saint John, IN
• Providers in Saint John, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.