Southeastern Mobile Dental Services Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOUTHEASTERN MOBILE DENTAL SERVICES INC

Practice address

18383 N Fork River Rd
Abingdon, VA 24210-4335

Phone

(615) 202-8864

NPI assigned

Apr 24, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Judy Jones

Title

Dental Director

Phone

(615) 202-8864

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1730354374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 RELAX DR # LO2",
            "city": "SMITHVILLE",
            "state": "TN",
            "postal_code": "371667351",
            "telephone_number": "615-215-7115",
            "fax_number": "615-215-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18383 N FORK RIVER RD",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242104335",
            "telephone_number": "615-202-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN MOBILE DENTAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "DENTAL DIRECTOR",
        "authorized_official_telephone_number": "615-202-8864",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Samuel Smith, PA-C
• Robin Smith
• Sydni Kaylyn Smith, MSW
• Damian Sooklal, MD
• Soulstice Nutrition LLC
• Southwest Emdr Therapy LLC
• Southwest Virginia Physicians for Women
• Jacob Sowder, LPC
• Kristen Leigh Sparks, FNP
• Anne Charlotte Squires, MD

• General Practice Dentistry in Abingdon, VA
• Providers in Abingdon, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.