Organization Active NPI

Smile Dentistry LLC

  • General Practice Dentistry
  • Thibodaux, LA
National Provider Identifier
1578038162
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SMILE DENTISTRY LLC
Practice address
1117 Canal Blvd
Thibodaux, LA 70301-4509
Phone
(985) 446-3855
NPI assigned
Oct 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Authorized official

Name
Renee Biondo, DDS
Title
Dentist/Owner
Phone
(985) 446-3855

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X

Addresses

Primary practice location

1117 Canal Blvd
Thibodaux, LA 70301-4509

Mailing address

205 Abby Lake Dr
Thibodaux, LA 70301-1633

National Provider Directory

National Provider Directory

Locations

1117 Canal Blvd
Thibodaux, LA 70301
Phone (985) 446-3855

Practitioners & affiliated clinicians

Practitioners 1

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": "1539129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539129600000",
    "number": "1578038162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 ABBY LAKE DR",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703011633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 CANAL BLVD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014509",
            "telephone_number": "985-446-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-10-10",
        "status": "A",
        "authorized_official_last_name": "BIONDO",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "985-446-3855",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; 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.