University Smiles LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

UNIVERSITY SMILES LLC

Doing business as

Creating Smiles Family and Cosmetic Dentistry Lebanon
Creating Smiles Lebanon

Practice address

229 W Saint Louis St # Sr
Lebanon, IL 62254-1515

Phone

(618) 304-5988

NPI assigned

Jul 21, 2020

Last updated

Jul 21, 2020By 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. Gena Farris Pineda, DDSNPI 1861518433

Title

Owner/Dentist

Phone

(618) 304-5988

Specialties & licenses 1

Addresses

Other names 2

• Creating Smiles Family and Cosmetic Dentistry Lebanon Doing business as
• Creating Smiles Lebanon Doing business as

Locations

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.

• Gena Pineda, DDS

  • Dentist
  • Boca Raton, FL
  • NPI 1861518433
  Authorized official Same address or phone

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1902414436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 W SAINT LOUIS ST",
            "city": "LEBANON",
            "state": "IL",
            "postal_code": "622541515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W SAINT LOUIS ST # SR",
            "city": "LEBANON",
            "state": "IL",
            "postal_code": "622541515",
            "telephone_number": "618-304-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY SMILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "PINEDA",
        "authorized_official_first_name": "GENA",
        "authorized_official_middle_name": "FARRIS",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "618-304-5988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creating Smiles Family and Cosmetic Dentistry Lebanon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Creating Smiles Lebanon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lance L Ringhausen, ATC
• Meritt Delanie Rittenhouse
• Charissa Lee Thorpe, O.D.
• Lori Toennies, P.T.
• Amber M Trevino, DAT, M.S, ATC, LAT
• Kristin Von Hatten, MS, ATC, CSCS
• Kimberly Ann Wagner
• Kimberly Wright, RN
• Abigail Zurliene

• General Practice Dentistry in Lebanon, IL
• Providers in Lebanon, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.