Smile Mission Baton Rouge LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SMILE MISSION BATON ROUGE LLC

Practice address

11103 Park Place Dr
Baton Rouge, LA 70818-3200

Phone

(786) 701-8246

NPI assigned

May 31, 2025

Organization subpart

No

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

Authorized official

Name

Dustin Pfundheller

Title

Manager

Phone

(786) 701-8246

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1748649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748649600000",
    "number": "1669365441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 SW 168TH ST STE 1",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331574378",
            "telephone_number": "786-701-8246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11103 PARK PLACE DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708183200",
            "telephone_number": "786-701-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE MISSION BATON ROUGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-31",
        "last_updated": "2025-05-31",
        "certification_date": "2025-05-31",
        "status": "A",
        "authorized_official_last_name": "PFUNDHELLER",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "786-701-8246"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Baton Rouge, LA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2025; 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.