NPIMap

Organization Active NPI

W&J Dental LLC

  • Dental Clinic/Center
  • Orlando, FL
National Provider Identifier
1619633815
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
W&J DENTAL LLC
Doing business as
GLOWING SMILE DENTAL STUDIO
Practice address
10231 E Colonial Dr
Orlando, FL 32817-4353
Phone
(407) 985-2885
Fax
(407) 985-2887
NPI assigned
Nov 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Authorized official

Name
Dr. Jood Bazerbashi, DDSNPI 1093317703
Title
Manager
Phone
(832) 661-8720

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

10231 E Colonial Dr
Orlando, FL 32817-4353

Mailing address

10231 E Colonial Dr
Orlando, FL 32817-4353
Phone (407) 985-2885

Other identifiers 2

IdentifierTypeStateIssuer
1518048065MedicaidFL
1093317703MedicaidFL

Other names 1

  • GLOWING SMILE DENTAL STUDIO Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1636588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1619633815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10231 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328174353",
            "telephone_number": "407-985-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10231 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328174353",
            "telephone_number": "407-985-2885",
            "fax_number": "407-985-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W&J DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-11",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "BAZERBASHI",
        "authorized_official_first_name": "JOOD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "832-661-8720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518048065",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093317703",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLOWING SMILE DENTAL STUDIO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.