Great Smiles Dental Care

Primary specialty

DentistTaxonomy code 122300000X

License

B13724222 Issued in AZ

Legal business name

GREAT SMILES DENTAL CARE

Practice address

14800 W. Mountain View Blvd
Suite 200
Surprise, AZ 85574

Phone

(623) 933-5749

Fax

(623) 815-1220

NPI assigned

Jul 18, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Eric Paul Wendelschafer, DMD

Title

Dentist

Phone

(480) 606-2630

Specialties & licenses 1

Addresses

Tax ID family

Ebw DMD PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ebw DMD PLLC

  • Dental Clinic/Center
  • Surprise, AZ
  • NPI 1922594522
  NPD tax ID

Locations

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1629554167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14800 W. MOUNTAIN VIEW BLVD",
            "address_2": "SUITE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85574",
            "telephone_number": "623-933-5749",
            "fax_number": "623-815-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 W. MOUNTAIN VIEW BLVD",
            "address_2": "SUITE 200",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85574",
            "telephone_number": "623-933-5749",
            "fax_number": "623-815-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT SMILES DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "WENDELSCHAFER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "480-606-2630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "B13724222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Gray, PTA
• Kyla Camille Gray, MSN, FNP-C, PMHNP-C
• Byron Kent Grayson, P.A
• Mary Ellen Grayson
• Brenda Graziano, LMSW
• Great Smiles Dental Group LLC
• Adara Greathouse
• Donovan Greathouse
• Charise Green, RB
• Chelsea Green

• Dentist in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Dentist in Arizona

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