Smile Revolution PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SMILE REVOLUTION PLLC

Doing business as

Grand Central Dentistry

Practice address

600 S Conroe Medical Drive
Ste 104
Conroe, TX 77304

Phone

(936) 666-4459

NPI assigned

Jan 2, 2018

Last updated

Jan 2, 2018By 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. Shivani Patel, DMD

Title

Owner

Phone

(936) 666-4459

Specialties & licenses 1

Addresses

Other names 1

• Grand Central Dentistry Doing business as

Locations

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514851200000",
    "number": "1649787524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 WOODLAND FIELD XING APT 316",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773803855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S CONROE MEDICAL DRIVE",
            "address_2": "STE 104",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "77304",
            "telephone_number": "936-666-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE REVOLUTION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-02",
        "last_updated": "2018-01-02",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SHIVANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-666-4459",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Central Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sleep Examinations LLC
• Megan Elizabeth Slomka, APRN, FNP-C
• SLP Conroe LLC (Woodland Manor Nursing and Rehabilitation)
• Smbsaifee Healthcare PLLC
• Smile Conroe, PA
• Smiles by Spates, LLC
• Jarrett Smilie, L.M.T., NASM-CPT
• Smilux Dental Studio PLLC
• Susanna J Louisa Smit
• Darrell Smith

• Dental Clinic/Center in Conroe, TX
• Providers in Conroe, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.