Smile Line Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS-036185 Issued in PA

Legal business name

SMILE LINE DENTAL

Practice address

625 N Charlotte St
Pottstown, PA 19464-4645

Phone

(610) 906-3389

Fax

(610) 828-1666

NPI assigned

Jan 20, 2011

Organization subpart

Yes

Parent organization

SMILE LINE DENTALAs reported in NPPES

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

Authorized official

Name

Dr. Sung Joo Jeong, D.D.S.

Title

Owner

Phone

(610) 828-1666

Specialties & licenses 1

Addresses

Tax ID family

Smile Line Dental2 organizations share this tax ID, including this one

Part of

Smile Line Dental

Other organizations with this tax ID 1

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

• Smile Line Dental

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1609171388
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Smile Line Dental

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1609171388
  NPPES parent name

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

{
    "created_epoch": "1295481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295481600000",
    "number": "1548565716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N CHARLOTTE ST",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194644645",
            "telephone_number": "610-906-3389",
            "fax_number": "610-828-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N CHARLOTTE ST",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194644645",
            "telephone_number": "610-906-3389",
            "fax_number": "610-828-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE LINE DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SMILE LINE DENTAL",
        "enumeration_date": "2011-01-20",
        "last_updated": "2011-01-20",
        "status": "A",
        "authorized_official_last_name": "JEONG",
        "authorized_official_first_name": "SUNG JOO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-828-1666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-036185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Slaby, BSW
• Erin Slack, LSW
• Emily Slater
• Gillian Slocum Ross, LCSW
• Deanna Slota, LPC
• Carrie May Smith-Ayoub
• Carolyn Smith, PT
• Casey Elizabeth Smith
• Christopher M Smith, DO
• Gabrielle Smith, MA

• General Practice Dentistry in Pottstown, PA
• Providers in Pottstown, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.