NPIMap

Organization Active NPI

An Elegant Smile P.C.

Doing business as An Elegant Smile Dentistry

  • General Practice Dentistry
  • Tucson, AZ
National Provider Identifier
1538488804
Registry record updated May 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7622 Issued in AZ
Legal business name
AN ELEGANT SMILE P.C.
Doing business as
An Elegant Smile Dentistry
Practice address
5977 E Grant Rd
Ste 115
Tucson, AZ 85712-2341
Phone
(520) 733-0040
Fax
(520) 546-0374
NPI assigned
May 25, 2010
Last updated
May 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2010

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

Authorized official

Name
Monica Vitela
Title
Credentialing Coordinator
Phone
(602) 482-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7622 AZ Primary

Addresses

Primary practice location

5977 E Grant Rd
Ste 115
Tucson, AZ 85712-2341

Mailing address

5977 E Grant Rd
Ste 115
Tucson, AZ 85712-2341
Phone (520) 733-0040

Other names 1

  • An Elegant Smile Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
An Elegant Smile PC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274745600000",
    "number": "1538488804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5977 E GRANT RD",
            "address_2": "STE 115",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122341",
            "telephone_number": "520-733-0040",
            "fax_number": "520-546-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5977 E GRANT RD",
            "address_2": "STE 115",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122341",
            "telephone_number": "520-733-0040",
            "fax_number": "520-546-0374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AN ELEGANT SMILE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-25",
        "last_updated": "2010-05-25",
        "status": "A",
        "authorized_official_last_name": "VITELA",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "602-482-7000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "7622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "An Elegant Smile Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; 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.