NPIMap

Organization Active NPI

An Elegant Smile P.C.

Doing business as An Elegant Smile Denistry

  • General Practice Dentistry
  • Peoria, AZ
National Provider Identifier
1760797146
Registry record updated Aug 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3531 Issued in AZ
Legal business name
AN ELEGANT SMILE P.C.
Doing business as
An Elegant Smile Denistry
Practice address
14155 N 83Rd Ave BLDG 3
Peoria, AZ 85381-5639
Phone
(623) 486-5222
Fax
(623) 486-5226
NPI assigned
Aug 10, 2010
Last updated
Aug 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2010

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

Authorized official

Name
Monica Vitela
Title
Credentialing Coordinator
Phone
(602) 482-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3531 AZ Primary

Addresses

Primary practice location

14155 N 83Rd Ave BLDG 3
Peoria, AZ 85381-5639

Mailing address

14155 N 83Rd Ave BLDG 3
Peoria, AZ 85381-5639
Phone (623) 486-5222

Other names 1

  • An Elegant Smile Denistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
An Elegant Smile PC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14155 N 83rd Ave
Bldg 3
Peoria, AZ 85381
Phone (623) 486-5222

NPI Registry JSON

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281398400000",
    "number": "1760797146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14155 N 83RD AVE BLDG 3",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815639",
            "telephone_number": "623-486-5222",
            "fax_number": "623-486-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14155 N 83RD AVE BLDG 3",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815639",
            "telephone_number": "623-486-5222",
            "fax_number": "623-486-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AN ELEGANT SMILE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-10",
        "last_updated": "2010-08-10",
        "status": "A",
        "authorized_official_last_name": "VITELA",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "602-482-7000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "3531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "An Elegant Smile Denistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; 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.