Smile Safari of Missouri

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SMILE SAFARI OF MISSOURI

Practice address

10016 E 63Rd St
Raytown, MO 64133-5102

Phone

(816) 313-8485

NPI assigned

Apr 11, 2019

Organization subpart

No

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

Authorized official

Name

Bonnie Brizendine

Title

Director of Operations

Phone

(614) 563-8681

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Lakshmi Harini Mallavarapu, DDS

  • Dentist
  • Las Vegas, NV
  • NPI 1154779684
  NPD (past)

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1538622071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 S MUR LEN RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660622611",
            "telephone_number": "913-353-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10016 E 63RD ST",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641335102",
            "telephone_number": "816-313-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE SAFARI OF MISSOURI",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-11",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "BRIZENDINE",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "614-563-8681"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renita T Simmons
• Christina Simms, COUNSELOR
• Madeline Grace Sloan, DDS
• Karie Slupianek, COTA/L
• Smile Care Raytown, LLC
• Smileshack Missouri, LLC
• Aaron Nelson Smith, RD
• Charles P Smith, R.N.
• Gary L. Smith, D.D.S.
• Lashae Smith, BSW MSW LMSW

• Dental Clinic/Center in Raytown, MO
• Providers in Raytown, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.