Organization Active NPI

Smilebliss by Dr. G.

  • Pediatric Dentistry
  • Plantation, FL
National Provider Identifier
1700571007
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
SMILEBLISS BY DR. G.
Practice address
10117 Cleary Boulevard
Plantation, FL 33324
Phone
(954) 326-2947
NPI assigned
Apr 11, 2023
Organization subpart
Yes
Parent organization
DR, GRANDISON DMDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Authorized official

Name
Mr. Nigel Grandison, DMD
Title
Officer
Phone
(954) 326-2947

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

10117 Cleary Boulevard
Plantation, FL 33324

Mailing address

10117 Cleary Boulevard
Plantation, FL 33324
Phone (954) 326-2947

Other identifiers 1

IdentifierTypeStateIssuer
075944900MedicaidFL

National Provider Directory

National Provider Directory
Part of
Smilebliss by Dr G

NPI Registry JSON

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1700571007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10117 CLEARY BOULEVARD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "33324",
            "telephone_number": "954-326-2947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10117 CLEARY BOULEVARD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "33324",
            "telephone_number": "954-326-2947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILEBLISS BY DR. G.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR, GRANDISON DMD",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "GRANDISON",
        "authorized_official_first_name": "NIGEL",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "954-326-2947",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075944900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.