Provider Demographics
NPI:1417413451
Name:28 SMILE, LLC
Entity Type:Organization
Organization Name:28 SMILE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:281-721-9575
Mailing Address - Street 1:11403 BARKER CYPRESS RD STE 1300
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5425
Mailing Address - Country:US
Mailing Address - Phone:281-721-9575
Mailing Address - Fax:281-721-9594
Practice Address - Street 1:11403 BARKER CYPRESS RD STE 1300
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-5425
Practice Address - Country:US
Practice Address - Phone:281-721-9575
Practice Address - Fax:281-721-9594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
1619424561OtherNPI
TX3735631Medicaid