Smile Design of Hallandale Beach LLC

Primary specialty

DentistTaxonomy code 122300000X

License

DN18962 Issued in FL

Legal business name

SMILE DESIGN OF HALLANDALE BEACH LLC

Practice address

2100 E Hallandale Beach Blvd
Ste 305
Hallandale Beach, FL 33009-3765

Phone

(954) 454-4949

Fax

(954) 454-4940

NPI assigned

Feb 15, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Nathalie Vera, DMD

Title

Pres

Phone

(954) 454-4949

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455494400000",
    "number": "1861851115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 E HALLANDALE BEACH BLVD",
            "address_2": "STE 305",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330093765",
            "telephone_number": "954-454-4949",
            "fax_number": "954-454-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E HALLANDALE BEACH BLVD",
            "address_2": "STE 305",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330093765",
            "telephone_number": "954-454-4949",
            "fax_number": "954-454-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE DESIGN OF HALLANDALE BEACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "status": "A",
        "authorized_official_last_name": "VERA",
        "authorized_official_first_name": "NATHALIE",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "954-454-4949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; 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.