Provider Demographics
NPI:1164633228
Name:SMILES AND BLESSINGS, INC.
Entity Type:Organization
Organization Name:SMILES AND BLESSINGS, INC.
Other - Org Name:SMILES AND BLESSINGS MOBILE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEMORE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:731-424-2651
Mailing Address - Street 1:332 LANE AVE
Mailing Address - Street 2:JCM HIGH SCHOOL
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-4577
Mailing Address - Country:US
Mailing Address - Phone:731-427-3351
Mailing Address - Fax:731-423-9711
Practice Address - Street 1:332 LANE AVE
Practice Address - Street 2:JCM HIGH SCHOOL
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-4577
Practice Address - Country:US
Practice Address - Phone:731-427-3351
Practice Address - Fax:731-423-9711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7773122300000X
251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No251V00000XAgenciesVoluntary or CharitableGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN186965OtherTENNCARE LOCATION
TN16031OtherTENNCARE PROVIDER #
TN219134OtherTENNCARE PAYEE