Smile Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

23838 Issued in TX

Legal business name

SMILE DENTAL PLLC

Practice address

3525 Broadway Street
Suite 101
Pearland, TX 77581

Phone

(281) 485-1133

Fax

(281) 485-1166

NPI assigned

May 8, 2009

Organization subpart

No

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

Authorized official

Name

Jacquelyn DO, DDSNPI 1902938046

Title

Owner/Dentist

Phone

(281) 485-1133

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Jacquelyn DO, DDS

  • Dentist
  • Pearland, TX
  • NPI 1902938046

  General Practice

  NPD Authorized official

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1487888160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 BROADWAY STREET",
            "address_2": "SUITE 101",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "77581",
            "telephone_number": "281-485-1133",
            "fax_number": "281-485-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 BROADWAY STREET",
            "address_2": "SUITE 101",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "77581",
            "telephone_number": "281-485-1133",
            "fax_number": "281-485-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-08",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "281-485-1133",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER IDENTIFICATION",
            "identifier": "D53206",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Aisha Nichole Smith-Shoemo, LPC-A
• Alysia Smith
• Bailee Smith, M.ED., BCBA

• General Practice Dentistry in Pearland, TX
• Providers in Pearland, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.