NPIMap

Organization Active NPI

Smiles R US Dental Care

  • General Practice Dentistry
  • Bolivar, TN
National Provider Identifier
1982734596
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7263 Issued in TN
Legal business name
SMILES R US DENTAL CARE
Practice address
407 W Lafayette St
Bolivar, TN 38008-2651
Phone
(731) 658-6112
Fax
(731) 658-6059
NPI assigned
Mar 6, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Anita Jo Parks, D.D.S.NPI 1134253305
Title
Dentist
Phone
(731) 658-6112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 7263 TN Primary

Addresses

Primary practice location

407 W Lafayette St
Bolivar, TN 38008-2651

Mailing address

407 W Lafayette St
Bolivar, TN 38008-2651
Phone (731) 658-6112

Other identifiers 4

IdentifierTypeStateIssuer
160348OtherTNDELTA DENTAL
4108150OtherTNBLUE CROSS BLUE SHIELD
16438MedicaidTN
1764104OtherPAUNITED CONCORDIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982734596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W LAFAYETTE ST",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380082651",
            "telephone_number": "731-658-6112",
            "fax_number": "731-658-6059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W LAFAYETTE ST",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380082651",
            "telephone_number": "731-658-6112",
            "fax_number": "731-658-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES R US DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "731-658-6112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "7263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "160348",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4108150",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16438",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1764104",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.