Provider Demographics
NPI:1497311336
Name:SMILE HQ DENTAL PLLC
Entity Type:Organization
Organization Name:SMILE HQ DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EMIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:USMAN-ALIU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:202-829-3100
Mailing Address - Street 1:4820 13TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-4410
Mailing Address - Country:US
Mailing Address - Phone:202-829-3100
Mailing Address - Fax:
Practice Address - Street 1:4820 13TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-4410
Practice Address - Country:US
Practice Address - Phone:202-829-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty