Jacksonville Smile Canter

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JACKSONVILLE SMILE CANTER

Practice address

1405 Braden St
Jacksonville, AR 72076-3720

Phone

(501) 241-2345

NPI assigned

Feb 26, 2019

Organization subpart

No

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

Authorized official

Name

Chad Matone, DDS

Title

Owner

Phone

(888) 377-3978

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552348800000",
    "number": "1962969949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 BRADEN ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720763720",
            "telephone_number": "501-241-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 BRADEN ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720763720",
            "telephone_number": "501-241-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE SMILE CANTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-03-12",
        "status": "A",
        "authorized_official_last_name": "MATONE",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-377-3978",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.