NPIMap

Organization Active NPI

Pediatric Smiles P.a.

  • Pediatric Dentistry
  • Bedford, TX
National Provider Identifier
1780893255
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
20602 Issued in TX
Legal business name
PEDIATRIC SMILES P.A.
Practice address
3004 Highway 121
Suite B
Bedford, TX 76021-4037
Phone
(817) 283-8600
Fax
(817) 283-8621
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Manivara Krone, D.D.S.NPI 1871609891
Title
President
Phone
(817) 283-8600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 20602 TX Primary

Addresses

Primary practice location

3004 Highway 121
Suite B
Bedford, TX 76021-4037

Mailing address

3004 Highway121
Suite B
Bedford, TX 76021-4037

National Provider Directory

National Provider Directory

Locations

3004 Highway 121
Ste B
Bedford, TX 76021
Phone (817) 283-8600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780893255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 HIGHWAY121",
            "address_2": "SUITE B",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760214037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 HIGHWAY 121",
            "address_2": "SUITE B",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760214037",
            "telephone_number": "817-283-8600",
            "fax_number": "817-283-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SMILES P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRONE",
        "authorized_official_first_name": "MANIVARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-283-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "20602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.