Smile Clubhouse

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

SMILE CLUBHOUSE

Practice address

2910 E Battlefield St
Springfield, MO 65804-4016

Phone

(417) 444-6776

NPI assigned

Oct 14, 2022

Last updated

Oct 14, 2022By 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. Trent Duane Madsen, DMDNPI 1639707649

Title

Owner

Phone

(480) 789-9554

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Trent Duane Madsen, DMD

  • Pediatric Dentistry
  • Springfield, MO
  • NPI 1639707649
  NPD Authorized official

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1952027591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 E BATTLEFIELD ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044016",
            "telephone_number": "417-444-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 E BATTLEFIELD ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044016",
            "telephone_number": "417-444-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE CLUBHOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A",
        "authorized_official_last_name": "MADSEN",
        "authorized_official_first_name": "TRENT",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-789-9554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400111093",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron W Small, PHARM D
• David Milton Small, DMD
• Elizabeth Nell Small, RPH
• Anne Amelia Smid, M.D.
• David Matthew Smid, M.D.
• Smile More, Smile Better, LLC
• Smith Management Services, LLC (Family Pharmacy #23)
• Smith Management Services, LLC (Family Pharmacy #11)
• Michael P. Smith-O'Brien, MD
• Aleida Marie Smith, PA

• Pediatric Dentistry in Springfield, MO
• Providers in Springfield, MO by specialty
• Pediatric Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.