Sunny Smiles LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SUNNY SMILES LLC

Doing business as

Sunny Smiles Dental Spa

Practice address

655 N Belair Rd
Evans, GA 30809-4219

Phone

(706) 850-4040

Fax

(706) 868-9200

NPI assigned

Oct 23, 2023

Organization subpart

No

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

Authorized official

Name

Blake Taylor Ross, DMDNPI 1225761828

Title

Owner

Phone

(706) 373-4587

Specialties & licenses 1

Addresses

Other names 1

• Sunny Smiles Dental Spa Doing business as

Tax ID family

Sunny Smiles Dental Spa2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sunny Smiles LLC

  • General Practice Dentistry
  • Evans, GA
  • NPI 1497537609
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Blake Taylor Ross, DMD

  • General Practice Dentistry
  • Evans, GA
  • NPI 1225761828
  NPD Authorized official

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1689456899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 N BELAIR RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094219",
            "telephone_number": "706-850-4040",
            "fax_number": "706-868-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 N BELAIR RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094219",
            "telephone_number": "706-850-4040",
            "fax_number": "706-868-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNY SMILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-21",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-373-4587",
        "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": "Sunny Smiles Dental Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mikayla Renee Stovall
• Loren Miranda Strouble
• Sasha Sullivan
• Melissa Lampp Sumner, APRN, BC
• Sunny Smiles LLC
• Laura Suppa, OT
• Surgery Center of Columbia County, LLC
• Gregory Tyler Swisstack
• Danisha Tankard
• Angel Tansley, CD(DONA)

• Dental Clinic/Center in Evans, GA
• Providers in Evans, GA by specialty
• Dental Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.