Smile More Dental 3 Corp

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

License

019027963 Issued in IL

Legal business name

SMILE MORE DENTAL 3 CORP

Practice address

1480 N Orchard Rd
#104
Aurora, IL 60506-7939

Phone

(630) 343-0543

NPI assigned

Feb 14, 2016

Organization subpart

No

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

Authorized official

Name

Sami Mohamed Diab, DDS

Title

Owner

Phone

(312) 451-7264

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1455408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455408000000",
    "number": "1740649193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 N ORCHARD RD",
            "address_2": "#104",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605067939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 N ORCHARD RD",
            "address_2": "#104",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605067939",
            "telephone_number": "630-343-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE MORE DENTAL 3 CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-14",
        "last_updated": "2016-02-14",
        "status": "A",
        "authorized_official_last_name": "DIAB",
        "authorized_official_first_name": "SAMI",
        "authorized_official_middle_name": "MOHAMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-451-7264",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "IL",
            "license": "019027963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019027963",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Slusarski, OTR/L
• Mandie Small
• Smart Eyes LLC
• Smile Circle PLLC
• Smile Family Dental Office PC
• Smiles of Aurora.
• Smith Healthcare Properties, LLC
• Quaniya Latrice Smith-Hayes
• Katherine Ann Smith-Myles, LMSW
• Alison Marie Smith, CF-SLP

• Developmental Disabilities Clinic/Center in Aurora, IL
• Providers in Aurora, IL by specialty
• Developmental Disabilities Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2016; 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.