Provider Demographics
NPI:1760661979
Name:CARE SMILES ORTHODONTICS
Entity Type:Organization
Organization Name:CARE SMILES ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST/PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HOANG
Authorized Official - Middle Name:T
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:303-337-2999
Mailing Address - Street 1:1344 S CHAMBERS RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-4096
Mailing Address - Country:US
Mailing Address - Phone:303-337-2999
Mailing Address - Fax:
Practice Address - Street 1:1344 S CHAMBERS RD
Practice Address - Street 2:SUITE 104
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-4096
Practice Address - Country:US
Practice Address - Phone:303-337-2999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9021122300000X, 1223G0001X, 1223P0300X, 1223X0400X
CO10242122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty