Provider Demographics
NPI:1578146726
Name:SAYURI SMITH, DMD, LLC
Entity Type:Organization
Organization Name:SAYURI SMITH, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAYURI
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-221-1206
Mailing Address - Street 1:3609 PARK EAST DR STE 411
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4309
Mailing Address - Country:US
Mailing Address - Phone:216-464-8985
Mailing Address - Fax:
Practice Address - Street 1:3609 PARK EAST DR STE 411
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4309
Practice Address - Country:US
Practice Address - Phone:216-464-8985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty