Provider Demographics
NPI:1134506447
Name:JHR SMILES LLC
Entity Type:Organization
Organization Name:JHR SMILES LLC
Other - Org Name:DESERT RIDGE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:H
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:505-890-3000
Mailing Address - Street 1:6521 PARADISE BLVD NW STE M
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-6199
Mailing Address - Country:US
Mailing Address - Phone:505-890-3000
Mailing Address - Fax:
Practice Address - Street 1:6521 PARADISE BLVD NW STE M
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-6199
Practice Address - Country:US
Practice Address - Phone:505-890-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD3645122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty