Smilecreator of Alabama LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SMILECREATOR OF ALABAMA LLC

Practice address

191 Herren Camp Rd
Dadeville, AL 36853-6719

Phone

(256) 373-8333

NPI assigned

Apr 26, 2023

Last updated

Apr 26, 2023By 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

Nilo Hernandez, DDS

Title

Doctor/Authorized Official

Phone

(256) 373-8333

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1952099111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 HERREN CAMP RD",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368536719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 HERREN CAMP RD",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368536719",
            "telephone_number": "256-373-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILECREATOR OF ALABAMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "NILO",
        "authorized_official_title_or_position": "DOCTOR/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "256-373-8333",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly A Robertson, CRNP
• Russell Hospital Corporation (Medical Park Family Care)
• Robert Alan Schuster, MD
• Ronny Wayne Sharpe, CRTT
• Megan Michelle Simpson, PHARM D.
• State of Alabama
• Still Waters Volunteer Fire & Rescue Inc
• Tallapoosa County
• Tallapoosa County Health Dept (Dadeville) STD
• Tallapoosa County Health Dept-Dadeville Adult Immun

• Oral and Maxillofacial Surgery (Dentist) in Dadeville, AL
• Providers in Dadeville, AL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.