Provider Demographics
NPI:1013476084
Name:BELLASMILES ORTHODONTICS PA
Entity Type:Organization
Organization Name:BELLASMILES ORTHODONTICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAILA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-389-5734
Mailing Address - Street 1:358 FAIRWAY POINTE CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-8515
Mailing Address - Country:US
Mailing Address - Phone:407-680-3197
Mailing Address - Fax:
Practice Address - Street 1:12001 AVALON LAKE DR STE K
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7399
Practice Address - Country:US
Practice Address - Phone:407-680-3197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty