Smile Street Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SMILE STREET DENTAL

Practice address

6618A Security Blvd
Woodlawn, MD 21207-4010

Phone

(410) 575-1833

Fax

(410) 803-5297

NPI assigned

Jan 27, 2020

Last updated

Feb 19, 2020By 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

Dr. Amber T Royal, DDSNPI 1437468576

Title

Ceo

Phone

(202) 569-6708

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Amber Therese Royal, DDS

  • Dentist
  • Woodlawn, MD
  • NPI 1437468576
  NPD Authorized official

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1629609888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6618A SECURITY BLVD",
            "city": "WOODLAWN",
            "state": "MD",
            "postal_code": "212074010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6618A SECURITY BLVD",
            "city": "WOODLAWN",
            "state": "MD",
            "postal_code": "212074010",
            "telephone_number": "410-575-1833",
            "fax_number": "410-803-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE STREET DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "ROYAL",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-569-6708",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynn Sandham
• Bridget D Schilling
• Miriam Schwartz
• Jonathan Joel Shepherd, M.D.
• Angalene Sims
• Spectera
• Lisa Miller Strand, LCSW-C
• Towanda Street, LCPC
• Natasha Nicole Sye, LMSW
• Titan Rehab Services

• Dental Clinic/Center in Woodlawn, MD
• Providers in Woodlawn, MD by specialty
• Dental Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.