Glowing Smiles LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

GLOWING SMILES LLC

Practice address

1701 N Green Valley Pkwy Ste 5E
Henderson, NV 89074-5889

Phone

(702) 576-1709

Fax

(702) 364-8134

NPI assigned

Nov 1, 2021

Last updated

Nov 8, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Karla Brown

Title

Office Manager

Phone

(702) 576-1709

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1811652282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 N GREEN VALLEY PKWY STE 5E",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745889",
            "telephone_number": "702-576-1709",
            "fax_number": "702-364-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N GREEN VALLEY PKWY STE 5E",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745889",
            "telephone_number": "702-576-1709",
            "fax_number": "702-364-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOWING SMILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "702-576-1709"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Henderson, NV
• Providers in Henderson, NV by specialty
• Pediatric Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.