Organization Active NPI

Smile Design Center

  • Dentist
  • Rockledge, FL
National Provider Identifier
1972048874
Registry record updated Dec 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN15965 Issued in FL
Legal business name
SMILE DESIGN CENTER
Practice address
5445 Village Dr Ste 100
Rockledge, FL 32955-6666
Phone
(321) 751-7775
NPI assigned
Dec 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2016

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

Authorized official

Name
Dr. Warren Christopher Edwards, DDS
Title
President
Phone
(321) 751-7775

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN15965 FL Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN20180 FL

Addresses

Primary practice location

5445 Village Dr Ste 100
Rockledge, FL 32955-6666

Mailing address

5445 Village Dr Ste 100
Rockledge, FL 32955-6666
Phone (321) 751-7775

National Provider Directory

National Provider Directory

Locations

5445 Village Dr
Ste 100
Rockledge, FL 32955
Phone (321) 751-7775

NPI Registry JSON

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

{
    "created_epoch": "1483142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483142400000",
    "number": "1972048874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 VILLAGE DR STE 100",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329556666",
            "telephone_number": "321-751-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 VILLAGE DR STE 100",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329556666",
            "telephone_number": "321-751-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE DESIGN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-31",
        "last_updated": "2016-12-31",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-751-7775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15965",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20180",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.

Verify at the official NPI Registry.