Provider Demographics
NPI:1639597073
Name:JMS BELTLINE DENTAL PLLC
Entity Type:Organization
Organization Name:JMS BELTLINE DENTAL PLLC
Other - Org Name:SMILEY DENTAL
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SEIBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:903-288-9066
Mailing Address - Street 1:PO BOX 543248
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-3248
Mailing Address - Country:US
Mailing Address - Phone:214-995-5149
Mailing Address - Fax:214-367-5896
Practice Address - Street 1:3109 N BELT LINE RD STE 110
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-6804
Practice Address - Country:US
Practice Address - Phone:214-995-5149
Practice Address - Fax:214-367-5896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty