Smile Station Family Dentistry, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

7956 Issued in KY

Legal business name

SMILE STATION FAMILY DENTISTRY, LLC

Practice address

5504 Reidland Rd
Paducah, KY 42003-0955

Phone

(270) 408-1234

NPI assigned

Jun 13, 2016

Last updated

Jun 13, 2016By 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. Donald Scott Bridges, DMD

Title

Member

Phone

(270) 519-7342

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465776000000",
    "number": "1689024465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 WINDSOR WOODS",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420014676",
            "telephone_number": "270-408-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5504 REIDLAND RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420030955",
            "telephone_number": "270-408-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE STATION FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-06-13",
        "status": "A",
        "authorized_official_last_name": "BRIDGES",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "270-519-7342",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "7956",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "KY",
            "license": "7956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sleep Source Inc
• Sleep Source Kentucky, LLC
• Sleep Source Kentucky, LLC
• Matthew J Sloan
• Barbara Jane Smalley, LCSW
• Daniel J. Smiley, CRNA
• Alyssa Paige Smith
• Bobbie Lee Smith, APRN
• Brian David Smith, PHARMD BCPS
• Cody Wade Smith, MS, CCC-SLP

• Dental Clinic/Center in Paducah, KY
• Providers in Paducah, KY by specialty
• Dental Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.