Active NPI
Happy Smiles of Port Saint Lucie
- Dentist
- Port Saint Lucie, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN16481
- Legal business name
- HAPPY SMILES OF PORT SAINT LUCIE
- Practice address
- 1100 SW St Lucie Blvd
206
Port Saint Lucie, FL 34986-1780 - Phone
- (772) 807-1451
- NPI assigned
- Mar 4, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Simon Leizgold
- Title
- Operations Manager
- Phone
- (772) 807-1451
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN16481 | FL | Primary |
Addresses
Primary practice location
1100 SW St Lucie Blvd
206
Port Saint Lucie, FL 34986-1780
Mailing address
1100 SW Saint Lucie Blvd
206
Port Saint Lucie, FL 34986
Phone (772) 807-1451
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000800101 | Medicaid | FL |
National Provider Directory
National Provider Directory- Tax ID family
- Happy Smiles of Port Saint Lucie
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Dentistry
- Fort Myers, FL
- NPI 1831660026
Locations
1100 SW Saint Lucie West Blvd
Ste 206
Port St Lucie, FL 34986
Phone (772) 807-1451
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- General Practice Dentistry
- Fort Myers, FL
- NPI 1831660026
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dentist
- Boca Raton, FL
- NPI 1104903301
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457049600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1457049600000",
"number": "1962862805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 SW SAINT LUCIE BLVD",
"address_2": "206",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "34986",
"telephone_number": "772-807-1451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 SW ST LUCIE BLVD",
"address_2": "206",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349861780",
"telephone_number": "772-807-1451"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAPPY SMILES OF PORT SAINT LUCIE",
"organizational_subpart": "NO",
"enumeration_date": "2016-03-04",
"last_updated": "2016-03-04",
"status": "A",
"authorized_official_last_name": "LEIZGOLD",
"authorized_official_first_name": "SIMON",
"authorized_official_title_or_position": "OPERATIONS MANAGER",
"authorized_official_telephone_number": "772-807-1451"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "FL",
"license": "DN16481",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000800101",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.