Ideal Smile Dentistry LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

IDEAL SMILE DENTISTRY LLC

Practice address

2979 N Lake Pkwy Ste 100
Columbus, GA 31909-2575

Phone

(678) 910-1716

NPI assigned

May 22, 2023

Last updated

May 30, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Seth WaldenNPI 1730634338

Title

Ceo

Phone

(678) 910-1716

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Seth Walden, DMD

  • General Practice Dentistry
  • Columbus, GA
  • NPI 1730634338
  NPD Authorized official

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1750073615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 PIEDMONT LAKE RD",
            "city": "PINE MOUNTAIN",
            "state": "GA",
            "postal_code": "318223558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 N LAKE PKWY STE 100",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092575",
            "telephone_number": "678-910-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL SMILE DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A",
        "authorized_official_last_name": "WALDEN",
        "authorized_official_first_name": "SETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-910-1716"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Carter Hyneman, DPM
• Zoey Hypes
• I Basilio MD, PC
• Aiwane Iboaya, D.O
• Akram Ibrahim, MD
• Idealsmile
• Daniel Ikeagu
• Anne Lyle Illges, OTR/L
• Illuminating Behavior Solutions LLC (Illuminating Behavior)
• Independent Physical Therapy of Ga LLC

• Dentist in Columbus, GA
• Providers in Columbus, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.