Astounding Bright Confident Smiles PC

Primary specialty

DentistTaxonomy code 122300000X

License

2901014832 Issued in MI

Legal business name

ASTOUNDING BRIGHT CONFIDENT SMILES PC

Practice address

5848 Applewood
1404
West Bloomfield, MI 48322-3488

Phone

(248) 626-5222

NPI assigned

Oct 12, 2011

Last updated

Oct 12, 2011By 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

Dr. Charzetta Moore, DDS

Title

President

Phone

(248) 626-5222

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318377600000",
    "number": "1871878793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14411 W 8 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482351619",
            "telephone_number": "248-626-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5848 APPLEWOOD",
            "address_2": "1404",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223488",
            "telephone_number": "248-626-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASTOUNDING BRIGHT CONFIDENT SMILES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-12",
        "last_updated": "2011-10-12",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHARZETTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-626-5222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901014832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in West Bloomfield, MI
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• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; 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.