Organization Active NPI

My Smile Dentistry LLC

  • Dentist
  • Cooper City, FL
National Provider Identifier
1801476163
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MY SMILE DENTISTRY LLC
Practice address
9640 Stirling Rd
Unit 101
Cooper City, FL 33024
Phone
(954) 400-0900
NPI assigned
Apr 12, 2021
Last updated
Apr 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Authorized official

Name
Dr. Kelly Gonzalez, DMDNPI 1952717027
Title
Dentist
Phone
(561) 212-8478

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
Dentist 122300000X NU Primary

Addresses

Primary practice location

9640 Stirling Rd
Unit 101
Cooper City, FL 33024

Mailing address

9640 Stirling Rd
Unit 101
Cooper City, FL 33024
Phone (954) 400-0900

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL info@mysmiledentistryfl.com Direct

National Provider Directory

National Provider Directory

Locations

9640 Stirling Rd
Unit 101
Hollywood, FL 33024
Phone (954) 400-0900

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1801476163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9640 STIRLING RD",
            "address_2": "UNIT 101",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "33024",
            "telephone_number": "954-400-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9640 STIRLING RD",
            "address_2": "UNIT 101",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "33024",
            "telephone_number": "954-400-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY SMILE DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-12",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "561-212-8478",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@mysmiledentistryfl.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Information",
            "address_1": "9640 stirling Rd",
            "address_2": "Unit 101",
            "city": "Cooper City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cooper City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.