NPIMap

Organization Active NPI

Great Smile Dental PLLC

  • Public Health Dentistry
  • Las Vegas, NV
National Provider Identifier
1568071827
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
Legal business name
GREAT SMILE DENTAL PLLC
Practice address
8445 W Flamingo Rd
Las Vegas, NV 89147-4166
Phone
(702) 309-0909
Fax
(725) 228-7025
NPI assigned
Jul 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Authorized official

Name
Jacqueline Morales
Title
District Manager
Phone
(847) 945-1050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223D0001X Primary

Addresses

Primary practice location

8445 W Flamingo Rd
Las Vegas, NV 89147-4166

Mailing address

720 Osterman Ave Ste 304
Deerfield, IL 60015-4339
Phone (847) 945-1050

Other practice location 1

2660 Windmill Pkwy
Henderson, NV 89074-3385
Phone (702) 309-0906

Other names 2

  • Great Smile Dental Las Vegas Doing business as
  • Great Smile Dental PLLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Great Smile Dental PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1568071827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 OSTERMAN AVE STE 304",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154339",
            "telephone_number": "847-945-1050",
            "fax_number": "847-940-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8445 W FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891474166",
            "telephone_number": "702-309-0909",
            "fax_number": "725-228-7025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2660 Windmill Pkwy",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890743385",
            "country_code": "US",
            "telephone_number": "702-309-0906",
            "fax_number": "725-215-0038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GREAT SMILE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "DISTRICT MANAGER",
        "authorized_official_telephone_number": "847-945-1050"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Smile Dental Las Vegas",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Great Smile Dental PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.