NPIMap

Organization Active NPI

Smiles on Main

  • Dentist
  • Maquoketa, IA
National Provider Identifier
1528015328
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7745 Issued in IA
Legal business name
SMILES ON MAIN
Practice address
119 South Main
Ste 1
Maquoketa, IA 52060
Phone
(563) 652-4133
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Authorized official

Name
Dr. Salvador D Atienza, DDSNPI 1275573206
Title
President
Phone
(563) 652-4133

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 7745 IA Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 8368 IA

Addresses

Primary practice location

119 South Main
Ste 1
Maquoketa, IA 52060

Mailing address

119 South Main
Ste 1
Maquoketa, IA 52060
Phone (563) 652-4133

Other identifiers 3

IdentifierTypeStateIssuer
8368OtherDELTA
0464354MedicaidIA
0116848MedicaidIA

National Provider Directory

National Provider Directory

Locations

119 S Main St
Ste 1
Maquoketa, IA 52060
Phone (563) 652-4133

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231113600000",
    "number": "1528015328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 SOUTH MAIN",
            "address_2": "STE 1",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "52060",
            "telephone_number": "563-652-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 SOUTH MAIN",
            "address_2": "STE 1",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "52060",
            "telephone_number": "563-652-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES ON MAIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2009-01-05",
        "status": "A",
        "authorized_official_last_name": "ATIENZA",
        "authorized_official_first_name": "SALVADOR",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-652-4133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IA",
            "license": "7745",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IA",
            "license": "8368",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA",
            "identifier": "8368",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0464354",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0116848",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maquoketa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.