Provider Demographics
NPI:1467006122
Name:ANKENY SMILES, LLC
Entity Type:Organization
Organization Name:ANKENY SMILES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCCARL
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:515-707-4848
Mailing Address - Street 1:3733 INDIANAPOLIS AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50317-6745
Mailing Address - Country:US
Mailing Address - Phone:515-707-4848
Mailing Address - Fax:
Practice Address - Street 1:225 SE ORALABOR RD STE 3
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-9118
Practice Address - Country:US
Practice Address - Phone:515-630-1816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty