Portable Smiles Mobile Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PORTABLE SMILES MOBILE INC

Practice address

519 Pinehurst Dr
Canton, MI 48188-3078

Phone

(313) 682-5888

NPI assigned

Jun 19, 2020

Organization subpart

No

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

Authorized official

Name

Sterling Cheeks

Title

Ceo

Phone

(313) 682-5888

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1760008361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 PINEHURST DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481883078",
            "telephone_number": "313-682-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 PINEHURST DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481883078",
            "telephone_number": "313-682-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTABLE SMILES MOBILE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "CHEEKS",
        "authorized_official_first_name": "STERLING",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-682-5888"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Ponomareva
• Jessica Poole
• Susan Lynne Popek-Boeve, CTRS
• Theresa Poppe, MD
• Portable Smiles Consulting LLC
• Inez Porter, LLMSW, MSW
• Danielle Patrice Potter-Bodenlos, D.C.
• Jessie L Potter, DC
• Robert Edward Potter Jr., DC
• Gerald Powell, DPT

• General Practice Dentistry in Canton, MI
• Providers in Canton, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.