Smile Square PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

29322 Issued in TX

Legal business name

SMILE SQUARE PLLC

Practice address

420 Plantation Dr
Lake Jackson, TX 77566-6145

Phone

(201) 920-7419

NPI assigned

Aug 21, 2014

Organization subpart

No

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

Authorized official

Name

Tejash Patel

Title

Owner

Phone

(201) 920-7419

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1922407352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 PLANTATION DR",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775666145",
            "telephone_number": "201-920-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 PLANTATION DR",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775666145",
            "telephone_number": "201-920-7419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE SQUARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-21",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "TEJASH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-920-7419"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.