Organization Active NPI

Smile Dental Studio, LLC.

  • Dental Clinic/Center
  • Rockville, MD
National Provider Identifier
1720870405
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SMILE DENTAL STUDIO, LLC.
Practice address
15215 Shady Grove Rd Ste 103
Rockville, MD 20850-6298
Phone
(301) 825-9245
Fax
(301) 296-6199
NPI assigned
May 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Authorized official

Name
Dr. Lili Ghazai, DDSNPI 1598811630
Title
Owner
Phone
(301) 825-9245

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

15215 Shady Grove Rd Ste 103
Rockville, MD 20850-6298

Mailing address

15215 Shady Grove Rd Ste 103
Rockville, MD 20850-6298
Phone (301) 825-9245

Other identifiers 1

IdentifierTypeStateIssuer
013259400MedicaidMD

National Provider Directory

National Provider Directory

Locations

15215 Shady Grove Rd
Ste 103
Rockville, MD 20850
Phone (301) 825-9245

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": "1747699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1720870405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15215 SHADY GROVE RD STE 103",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506298",
            "telephone_number": "301-825-9245",
            "fax_number": "301-296-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15215 SHADY GROVE RD STE 103",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506298",
            "telephone_number": "301-825-9245",
            "fax_number": "301-296-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE DENTAL STUDIO, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "GHAZAI",
        "authorized_official_first_name": "LILI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-825-9245",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013259400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; 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.