Organization Active NPI

Smile Today Peoria, PLC

  • General Practice Dentistry
  • Peoria, AZ
National Provider Identifier
1982076824
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SMILE TODAY PEORIA, PLC
Practice address
13460 N 94TH Dr
Suite H-2
Peoria, AZ 85381-4835
Phone
(602) 748-4717
NPI assigned
Oct 29, 2015
Last updated
Oct 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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

Authorized official

Name
John E Ballard
Title
Cfo, Cio
Phone
(480) 889-9457

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

13460 N 94TH Dr
Suite H-2
Peoria, AZ 85381-4835

Mailing address

4435 E Holmes Ave
Mesa, AZ 85206-3372
Phone (480) 889-9457

National Provider Directory

National Provider Directory

Locations

13460 N 94th Dr
Ste H2
Peoria, AZ 85381
Phone (602) 748-4717

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446076800000",
    "number": "1982076824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4435 E HOLMES AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063372",
            "telephone_number": "480-889-9457",
            "fax_number": "480-696-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13460 N 94TH DR",
            "address_2": "SUITE H-2",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814835",
            "telephone_number": "602-748-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE TODAY PEORIA, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-29",
        "last_updated": "2015-10-29",
        "status": "A",
        "authorized_official_last_name": "BALLARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO, CIO",
        "authorized_official_telephone_number": "480-889-9457"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; 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.