NPIMap

Organization Active NPI

Decatur Smiles

  • Dentist
  • Decatur, TX
National Provider Identifier
1801274659
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30234 Issued in TX
Legal business name
DECATUR SMILES
Practice address
301 W Main St
Decatur, TX 76234-1383
Phone
(940) 627-3730
Fax
(903) 465-1134
NPI assigned
May 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Authorized official

Name
Benjamin Allen Clark, DMD
Title
Dentist
Phone
(940) 627-3730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 30234 TX Primary

Addresses

Primary practice location

301 W Main St
Decatur, TX 76234-1383

Mailing address

301 W Main St
Decatur, TX 76234-1383
Phone (940) 627-3730

Other names 1

  • Smart Mouth Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

301 W Main St
Decatur, TX 76234
Phone (940) 627-3730

Practitioners & affiliated clinicians

Practitioners 2

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": "1431475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1801274659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W MAIN ST",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762341383",
            "telephone_number": "940-627-3730",
            "fax_number": "903-465-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W MAIN ST",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762341383",
            "telephone_number": "940-627-3730",
            "fax_number": "903-465-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR SMILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-13",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "940-627-3730",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "30234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smart Mouth Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.