The Smile Store, LLC

Primary specialty

DenturistTaxonomy code 122400000X

Legal business name

THE SMILE STORE, LLC

Practice address

740 Avenue H Ste 2
Seaside, OR 97138-6619

Phone

(503) 738-1860

Fax

(833) 200-5256

NPI assigned

Feb 16, 2018

Last updated

Jul 9, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Keith Ronald Cunning

Title

President

Phone

(833) 900-1050

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 6

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.

• Stephen Depirro II, LD

  • Denturist
  • Seaside, OR
  • NPI 1548760630
  NPD (past)
• Austin Mitchell Newsome, LD

  • Denturist
  • Coos Bay, OR
  • NPI 1093372039
  NPD (past)
• John Choi I, DN60731854

  • Denturist
  • Auburn, WA
  • NPI 1780175760
  NPD (past)
• Trang Phung, CH61614560

  • Chiropractor
  • Seattle, WA
  • NPI 1538633664

  Denturist

  NPD (past)
• John Unsicker, LD

  • Denturist
  • Auburn, WA
  • NPI 1669796538
  NPD (past)
• Hyun Jin You

  • Denturist
  • Marysville, WA
  • NPI 1124519103
  NPD (past)

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562630400000",
    "number": "1629578539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9597 CENTRAL AVE",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632424",
            "telephone_number": "833-900-1050",
            "fax_number": "833-200-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 AVENUE H STE 2",
            "city": "SEASIDE",
            "state": "OR",
            "postal_code": "971386619",
            "telephone_number": "503-738-1860",
            "fax_number": "833-200-5256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1242 State Ave Ste G",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "WA",
            "postal_code": "982703672",
            "country_code": "US",
            "telephone_number": "425-426-2305",
            "fax_number": "833-200-5256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9591 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "CA",
            "postal_code": "917632424",
            "country_code": "US",
            "telephone_number": "833-900-1050",
            "fax_number": "833-200-5256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1251 Auburn Way N",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "WA",
            "postal_code": "980024148",
            "country_code": "US",
            "telephone_number": "253-300-1860",
            "fax_number": "833-200-5256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE SMILE STORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-16",
        "last_updated": "2019-07-09",
        "status": "A",
        "authorized_official_last_name": "CUNNING",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "833-900-1050"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EMAIL",
            "affiliation": "N",
            "endpointDescription": "SECURE EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "SECURE EMAIL",
            "address_1": "9591 Central Ave",
            "city": "Montclair",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917632424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily Elizabeth Sullivan, PHARMD, BCACP
• Joseph Alphonse Sutton, RPH
• Kristin Tallman, PHARM.D.
• Katrina Tan
• The Lotus Center for Neurodiversity
• Emmalee Thornton, PHARMD, BCPS
• Thrifty Payless Inc (Rite Aid Pharmacy 05342)
• Amber Marie Toomey, FNP-C
• Jodi Vantress
• Kyle D Walker, MD

• Denturist in Seaside, OR
• Providers in Seaside, OR by specialty
• Denturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.