Sweet Smiles Grafton LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SWEET SMILES GRAFTON LLC

Practice address

1300 Bridge St
Grafton, WI 53024-1948

Phone

(262) 377-0807

NPI assigned

Jan 15, 2014

Organization subpart

No

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

Authorized official

Name

Pavan Gorantla

Title

Manager

Phone

(262) 377-0807

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1598187247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 BRIDGE ST",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530241948",
            "telephone_number": "262-377-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 BRIDGE ST",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530241948",
            "telephone_number": "262-377-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEET SMILES GRAFTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "GORANTLA",
        "authorized_official_first_name": "PAVAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "262-377-0807"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anton Strunets, MD
• Ellen L Suelflow, CRNA
• Maeve Sullivan, MS
• Abhishek Sundaram, M.B.B.S
• Angela M Sweeney, MSN APNP
• Mary K Swiderski, MD
• Austin James Taylor, LPC
• Erika L Tendolle, NP
• Heather Christia Teplin, PT
• Rozalin Thapa, D.O.

• General Practice Dentistry in Grafton, WI
• Providers in Grafton, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.