Small Smiles of Greeley, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SMALL SMILES OF GREELEY, PC

Practice address

2400 W 16TH St
Greeley, CO 80634-6004

Phone

(970) 395-1000

Fax

(970) 395-9811

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Jenell Stringer

Title

Manager, Licensing & Credentialing

Phone

(615) 750-0343

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370822400000",
    "number": "1730259128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ARCADE UNIT 198747",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372191994",
            "telephone_number": "615-750-0343",
            "fax_number": "615-986-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806346004",
            "telephone_number": "970-395-1000",
            "fax_number": "970-395-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMALL SMILES OF GREELEY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2013-06-10",
        "status": "A",
        "authorized_official_last_name": "STRINGER",
        "authorized_official_first_name": "JENELL",
        "authorized_official_title_or_position": "MANAGER, LICENSING & CREDENTIALING",
        "authorized_official_telephone_number": "615-750-0343",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026107200",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88174263",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Greeley, CO
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; 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.