NPIMap

Organization Active NPI

Smile 4 Life, P.C.

  • Dentist
  • Commerce City, CO
National Provider Identifier
1720210339
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SMILE 4 LIFE, P.C.
Doing business as
Smile 4 Life Dental
Practice address
12253 E 104TH Place
Suite 105
Commerce City, CO 80022
Phone
(303) 853-8000
Fax
(303) 288-2219
NPI assigned
Aug 14, 2009
Organization subpart
Yes
Parent organization
SMILE 4 LIFE, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 12, 2017

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

Authorized official

Name
Jennie Macumber, R.D.H.
Title
President
Phone
(303) 829-9243

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
Dental HygienistGroup: 193200000X MULTI-SPECIALTY GROUP 124Q00000X 903823 CO

Addresses

Primary practice location

12253 E 104TH Place
Suite 105
Commerce City, CO 80022

Mailing address

12253 E 104TH Place
Suite 105
Commerce City, CO 80022
Phone (303) 853-8000

Other names 1

  • Smile 4 Life Dental Doing business as

National Provider Directory

National Provider Directory

Locations

12253 E 104th Pl
Unit 105
Commerce City, CO 80022
Phone (303) 853-8000

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1250208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494547200000",
    "number": "1720210339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12253 E 104TH PLACE",
            "address_2": "SUITE 105",
            "city": "COMMERCE CITY",
            "state": "CO",
            "postal_code": "80022",
            "telephone_number": "303-853-8000",
            "fax_number": "303-288-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12253 E 104TH PLACE",
            "address_2": "SUITE 105",
            "city": "COMMERCE CITY",
            "state": "CO",
            "postal_code": "80022",
            "telephone_number": "303-853-8000",
            "fax_number": "303-288-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE 4 LIFE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SMILE 4 LIFE, P.C.",
        "enumeration_date": "2009-08-14",
        "last_updated": "2017-05-12",
        "status": "A",
        "authorized_official_last_name": "MACUMBER",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-829-9243",
        "authorized_official_credential": "R.D.H."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "903823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile 4 Life Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Commerce City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; 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.