Great Expression Smiles

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

GREAT EXPRESSION SMILES

Practice address

200 E Main St Ste C
Crowley, TX 76036-2600

Phone

(817) 297-4068

Fax

(817) 665-3822

NPI assigned

May 13, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Tri Pham, DDS

Title

President

Phone

(817) 496-2343

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Great Expression Smiles Doing business as

Tax ID family

Great Expression Smiles4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Great Expression Smiles

  • Preferred Provider Organization
  • Fort Worth, TX
  • NPI 1235540253
  NPD tax ID
• Great Expression Smiles

  • Preferred Provider Organization
  • Fort Worth, TX
  • NPI 1568873677
  NPD tax ID
• Great Expression Smiles

  • Dentist
  • Fort Worth, TX
  • NPI 1750769071
  NPD tax ID

Locations

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399939200000",
    "number": "1962813980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E MAIN ST STE C",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760362600",
            "telephone_number": "817-297-4068",
            "fax_number": "817-665-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E MAIN ST STE C",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760362600",
            "telephone_number": "817-297-4068",
            "fax_number": "817-665-3822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT EXPRESSION SMILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-13",
        "last_updated": "2014-05-13",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "TRI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-496-2343",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202009121",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Expression Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria Godi
• Clarissa Gonzales, LMT
• Lauren Gonzalez
• Natalie Nichole Gorecki
• Nichole D Graves
• Erin Reed Greer, DDS
• Cynthia Loy Grimm, LCSW
• H.I.S.Health Informatics Solutions
• Allison Hammer, APRN, CPNP-PC
• Jacqueline Hanes, RN

• Preferred Provider Organization in Crowley, TX
• Providers in Crowley, TX by specialty
• Preferred Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; 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.