Provider Demographics
NPI:1245771955
Name:SMILEY DENTAL, LLC
Entity Type:Organization
Organization Name:SMILEY DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:913-402-8888
Mailing Address - Street 1:13430 BRIAR DR
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3411
Mailing Address - Country:US
Mailing Address - Phone:913-402-8888
Mailing Address - Fax:913-402-8808
Practice Address - Street 1:13430 BRIAR DR
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209-3411
Practice Address - Country:US
Practice Address - Phone:913-402-8888
Practice Address - Fax:913-402-8808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS603461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty