NPIMap

Organization Active NPI

Orthodontic Smile Design, PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Grand Prairie, TX
National Provider Identifier
1831554708
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
21607 Issued in TX
Legal business name
ORTHODONTIC SMILE DESIGN, PC
Practice address
325 W Westchester Pkwy
Suite 100
Grand Prairie, TX 75052-2857
Phone
(972) 263-1755
Fax
(972) 264-6226
NPI assigned
Dec 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Authorized official

Name
Fernan Rodriguez, D.D.S, M.S.NPI 1639298235
Title
President
Phone
(972) 263-1755

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X TX
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 21607 TX Primary

Addresses

Primary practice location

325 W Westchester Pkwy
Suite 100
Grand Prairie, TX 75052-2857

Mailing address

325 W Westchester Pkwy
Suite 100
Grand Prairie, TX 75052-2857
Phone (972) 263-1755

Other names 1

  • Smile Design Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

325 W Westchester Pkwy
Ste 100
Grand Prairie, TX 75052
Phone (972) 263-1755

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": "1450656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1831554708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W WESTCHESTER PKWY",
            "address_2": "SUITE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750522857",
            "telephone_number": "972-263-1755",
            "fax_number": "972-264-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W WESTCHESTER PKWY",
            "address_2": "SUITE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750522857",
            "telephone_number": "972-263-1755",
            "fax_number": "972-264-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTIC SMILE DESIGN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "FERNAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-263-1755",
        "authorized_official_credential": "D.D.S, M.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "21607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Design Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.