Provider Demographics
NPI:1821427170
Name:LITTLE SMILES LLC
Entity Type:Organization
Organization Name:LITTLE SMILES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:WARSAME
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:614-805-5821
Mailing Address - Street 1:1390 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-2767
Mailing Address - Country:US
Mailing Address - Phone:614-805-5821
Mailing Address - Fax:
Practice Address - Street 1:1390 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-2767
Practice Address - Country:US
Practice Address - Phone:614-805-5821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.023314122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty