Active NPI
Smile Designers LLC
- Dentist
- Laurel, MS
National Provider Identifier
1578900718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 256990
- Legal business name
- SMILE DESIGNERS LLC
- Practice address
- 1709 W 20TH St
Laurel, MS 39440-1802 - Phone
- (601) 649-4854
- Fax
- (601) 651-6439
- NPI assigned
- May 29, 2013
- Last updated
- May 29, 2013
- Organization subpart
- Yes
- Parent organization
- SMILE DESIGNERS LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Keisha Denyel Quinn, D.D.S.
- Title
- Presudent
- Phone
- (601) 649-4854
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 256990 | MS | Primary |
Addresses
Primary practice location
1709 W 20TH St
Laurel, MS 39440-1802
Mailing address
1709 W 20TH St
Laurel, MS 39440-1802
Phone (601) 649-4854
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02303099 | Medicaid | MS | |
| 00060078 | Medicaid | MS |
National Provider Directory
National Provider Directory- Part of
- Smile Designers LLC
Locations
1709 W 20th St
Laurel, MS 39440
Phone (601) 649-4854
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- General Practice Dentistry
- Laurel, MS
- NPI 1518032432
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369785600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1369785600000",
"number": "1578900718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1709 W 20TH ST",
"city": "LAUREL",
"state": "MS",
"postal_code": "394401802",
"telephone_number": "601-649-4854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1709 W 20TH ST",
"city": "LAUREL",
"state": "MS",
"postal_code": "394401802",
"telephone_number": "601-649-4854",
"fax_number": "601-651-6439"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SMILE DESIGNERS LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SMILE DESIGNERS LLC",
"enumeration_date": "2013-05-29",
"last_updated": "2013-05-29",
"status": "A",
"authorized_official_last_name": "QUINN",
"authorized_official_first_name": "KEISHA",
"authorized_official_middle_name": "DENYEL",
"authorized_official_title_or_position": "PRESUDENT",
"authorized_official_telephone_number": "601-649-4854",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "MS",
"license": "256990",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02303099",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00060078",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.