Provider Demographics
NPI:1629791330
Name:512 SMILES, PLLC
Entity Type:Organization
Organization Name:512 SMILES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEGHPARA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:440-823-0575
Mailing Address - Street 1:4005 SPICEWOOD SPRINGS RD STE C500
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8672
Mailing Address - Country:US
Mailing Address - Phone:512-835-9557
Mailing Address - Fax:
Practice Address - Street 1:4005 SPICEWOOD SPRINGS RD STE C500
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8672
Practice Address - Country:US
Practice Address - Phone:512-835-9557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental