Provider Demographics
NPI:1568990778
Name:USMILE OF NMB, LLC
Entity Type:Organization
Organization Name:USMILE OF NMB, LLC
Other - Org Name:USMILE DENTAL CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRIEND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-915-8080
Mailing Address - Street 1:8962 CLEARY BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324
Mailing Address - Country:US
Mailing Address - Phone:954-915-8080
Mailing Address - Fax:954-915-0171
Practice Address - Street 1:1400 NE MIAMI GARDENS DRIVE
Practice Address - Street 2:SUITE 215
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179
Practice Address - Country:US
Practice Address - Phone:305-956-9996
Practice Address - Fax:305-956-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-01
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty