Provider Demographics
NPI:1255133385
Name:SMILE DESIGN
Entity type:Organization
Organization Name:SMILE DESIGN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:IVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ VILLELA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:915-792-2969
Mailing Address - Street 1:6101 GATEWAY W, SPC 520, PMB 313
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1829 MONTEBELLO
Practice Address - Street 2:
Practice Address - City:JUAREZ
Practice Address - State:MEXICO
Practice Address - Zip Code:32530
Practice Address - Country:MX
Practice Address - Phone:915-792-2969
Practice Address - Fax:915-465-5912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty