Springfield Smiles LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SPRINGFIELD SMILES LLC

Practice address

1722 S Glenstone Ave Ste O
Springfield, MO 65804-1513

Phone

(417) 501-8601

Fax

(417) 501-8602

NPI assigned

Apr 24, 2018

Organization subpart

No

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

Authorized official

Name

Tamela J Jones

Title

Practice Administrator

Phone

(417) 501-8601

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524528000000",
    "number": "1710475835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 S GLENSTONE AVE STE O",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658041513",
            "telephone_number": "417-501-8601",
            "fax_number": "417-501-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 S GLENSTONE AVE STE O",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658041513",
            "telephone_number": "417-501-8601",
            "fax_number": "417-501-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD SMILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-04-24",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TAMELA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "417-501-8601"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.