Provider Demographics
NPI:1821406281
Name:SMILE RITE ORLANDO PLLC
Entity Type:Organization
Organization Name:SMILE RITE ORLANDO PLLC
Other - Org Name:SMILE RITE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-972-4455
Mailing Address - Street 1:7014 PETTIGREW DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6646
Mailing Address - Country:US
Mailing Address - Phone:713-972-4455
Mailing Address - Fax:
Practice Address - Street 1:3310 ORLANDO ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77093-4855
Practice Address - Country:US
Practice Address - Phone:713-742-5020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-30
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179245902Medicaid