Montgomery Smile Center LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MONTGOMERY SMILE CENTER LLC

Doing business as

Montgomery Mall Smile Center

Practice address

154 Montgomery Mall
North Wales, PA 19454-3909

Phone

(215) 475-5140

NPI assigned

Apr 18, 2023

Organization subpart

No

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

Authorized official

Name

Kiril Sharkov

Title

Office Manager

Phone

(215) 391-5939

Specialties & licenses 1

Addresses

Other names 1

• MONTGOMERY MALL SMILE CENTER Doing business as

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1619664836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 MONTGOMERY MALL",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194543909",
            "telephone_number": "215-475-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 MONTGOMERY MALL",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194543909",
            "telephone_number": "215-475-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY SMILE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "SHARKOV",
        "authorized_official_first_name": "KIRIL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "215-391-5939"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MONTGOMERY MALL SMILE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gabrielle Minich, PT
• Usman Ahmed Mirza, RPH
• Matthew Booth Mitchell, D.C.
• Montgomery County Wellness Center (Montgomery County Chiropractic Center)
• Montgomery Mall Dental, LLP
• Jessica Sungae Moon
• Ji Weon Moon, ACUPUNCTURIST
• Sunghoon Moon
• Regina Adell Moore-Williams, OTR/L
• Heather E Moore, DPT

• General Practice Dentistry in North Wales, PA
• Providers in North Wales, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.