NPIMap

Organization Active NPI

Phoenix Dental Providers, Inc.

Doing business as Smile Clinique

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1497123996
Registry record updated Sep 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D05888 Issued in AZ
Legal business name
PHOENIX DENTAL PROVIDERS, INC.
Doing business as
Smile Clinique
Practice address
6520 N 7TH Ave
Suite 5
Phoenix, AZ 85013-1173
Phone
(602) 730-7012
NPI assigned
Sep 14, 2015
Last updated
Sep 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2015

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

Authorized official

Name
Mr. Youssef Salloum
Title
Business Owner
Phone
(602) 730-7012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D05888 AZ Primary

Addresses

Primary practice location

6520 N 7TH Ave
Suite 5
Phoenix, AZ 85013-1173

Mailing address

6520 N 7TH Ave
Suite 5
Phoenix, AZ 85013-1173
Phone (602) 730-7012

Other names 1

  • Smile Clinique Doing business as

National Provider Directory

National Provider Directory

Locations

6520 N 7th Ave
Ste 5
Phoenix, AZ 85013
Phone (602) 242-2588

NPI Registry JSON

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1497123996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 N 7TH AVE",
            "address_2": "SUITE 5",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850131173",
            "telephone_number": "602-730-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 N 7TH AVE",
            "address_2": "SUITE 5",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850131173",
            "telephone_number": "602-730-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX DENTAL PROVIDERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "SALLOUM",
        "authorized_official_first_name": "YOUSSEF",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "602-730-7012",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D05888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Clinique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; 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.