Small Smiles Pediatric Dentistry P.C.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

285140-9923 Issued in UT

Legal business name

SMALL SMILES PEDIATRIC DENTISTRY P.C.

Practice address

1300 N 200 E
Suite 102
Logan, UT 84341-2398

Phone

(435) 792-3033

Fax

(435) 792-3233

NPI assigned

May 8, 2007

Organization subpart

No

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

Authorized official

Name

Melody Jean Fryer

Title

Office Manager

Phone

(435) 792-3033

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Dr Doug'S Pediatric Dentistry PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dr. Doug'S Pediatric Dentistry P.C.

  • Pediatric Dentistry
  • Logan, UT
  • NPI 1780004267
  NPD tax ID

Locations

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922211523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 200 E",
            "address_2": "SUITE 102",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412398",
            "telephone_number": "435-792-3033",
            "fax_number": "435-792-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 200 E",
            "address_2": "SUITE 102",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412398",
            "telephone_number": "435-792-3033",
            "fax_number": "435-792-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMALL SMILES PEDIATRIC DENTISTRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRYER",
        "authorized_official_first_name": "MELODY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "435-792-3033"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "285140-9923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529376727002",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert D Skillman
• Brett T Skinner, DDS PC
• Caden Brett Skinner, DMD
• Candace Lee Slater, DPT
• Sleep Well Idaho LLC
• Jason C Smart, MD
• Katelyn Smartt
• Ashley Kaye Smedley
• Angela Knowles Smith, DPT
• B Renee Smith

• Pediatric Dentistry in Logan, UT
• Providers in Logan, UT by specialty
• Pediatric Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.