GREAT SMILE DENTAL (NPI# 1013472687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013472687 |
| Entity Type | Organization |
| Organization Name | GREAT SMILE DENTAL |
| Practice Address |
26425 Ne Allen St Ste 102 Duvall WA 98019-8628 |
| Practice Telephone | 4257881551 |
| Mailing Telephone | 4257881551 |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2019-02-07 |
| Authorized Official Name | CHELSEA D MORTELL (DENTIST/OWNER) |
| Authorized Official Telephone | 4257881551 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NA | NA | 01 |
| Other Name | Type Code |
|---|---|
| Great Smile Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457499642 | Great Smile Dental | Dentist | 2145 Roswell Rd, Ste 120, Marietta, GA 30062-0821 | 2007-02-01 |
| 1629467881 | Great Smile Dental | Clinic/Center | 900 N Randolph St, Suite #103, Arlington, VA 22203-1949 | 2015-01-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Great Smile Dental Corporation | 900 N Randolph St, Ste 103, Arlington, Virginia 22203 |
| Colorado Business Entities | Great Smile Dental Group LLC | 629 E Star Ct, Montrose, CO 81401 |
| Connecticut Business Registrations | Great Smile Dental Service, P.C. | 629 W 185th Street, 4th Floor, New York, NY 10033 |
| New York State Corporations | GREAT SMILE DENTAL SERVICE, P.C. | 629 West 185th Street, 4th Flr, New York, Ny 10033 |
| Street Address |
26425 NE ALLEN ST STE 102 |
| City | DUVALL |
| State | WA |
| Zip Code | 98019-8628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598240202 | Emily Ellen Squiers | Counselor | 26420 Virginia St, Suite 2, Duvall, WA 98019 | 2018-09-27 |
| 1235629072 | Aubrey Christine Lane | Marriage & Family Therapist | Larch Counseling 15315 1st Avenue Northeast, #205-a, Duvall, WA 98019 | 2018-05-17 |
| 1528505575 | Jackie Schaedler Boak | Registered Nurse | 15309 2nd Ave Ne, Duvall, WA 98019 | 2017-01-30 |
| 1912326778 | Dan Claussen | Marriage & Family Therapist | 15315 Ne 1st Ave Ne, Suite 205-a, Duvall, WA 98019 | 2014-04-09 |
| 1134405509 | Amy R Bush | Physical Therapist | 15435 Main St. Ne #101, Duvall, WA 98019 | 2011-10-28 |
| 1407134919 | Cynthia Rebecca Tyler | Dentist | 26504 Ne Valley Street, Duvall, WA 98019 | 2011-08-01 |
| 1215256730 | Diane Zakrajsek | Dietitian, Registered | 26502 Ne Valley Street Suite 102, Duvall, WA 98019 | 2010-05-24 |
| 1093917320 | Jolynn Wagner | Psychologist | 26502 Ne Valley St Suite 101, Duvall, WA 98019 | 2007-05-31 |
| 1760690242 | Rebecca Jean Maxcy | Specialist | 15705 Main St, Duvall, WA 98019 | 2007-05-18 |
| 1538377064 | The Camelot Society | Intermediate Care Facility, Mentally Retarded | 26509 N.e. Virginia St., Duvall, WA 98019 | 2007-05-18 |
| Find all providers in zip 98019 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811264005 | Emma Etemadi, Dds, Ps | Clinic/Center | 14142 Main St Ne, Suite 104, Duvall, WA 98019-9007 | 2011-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700671 | K.lee, Dds, Pllc. | Clinic/Center | 20709 Mountain Hwy E # 102, Spanaway, WA 98387-8580 | 2020-11-06 |
| 1346841376 | Ralf F. Schuler, Dr. Med. Dent., Msd,pllc | Clinic/Center | 205 W Fairhaven Ave Ste C, Burlington, WA 98233-1062 | 2020-11-05 |
| 1356942684 | Healthy Smiles Northwest | Clinic/Center | 11808 18th St Se, Lake Stevens, WA 98258-2046 | 2020-11-03 |
| 1306446240 | Christine A Woodward, Dds, Pllc | Clinic/Center | 45860 Main St, Concrete, WA 98237 | 2020-10-29 |
| 1215535695 | Ellingsen Henneberg Pllc | Clinic/Center | 2607 S Southeast Blvd Ste B210, Spokane, WA 99223-7614 | 2020-10-16 |
| 1174121792 | Evolve Dental LLC | Clinic/Center | 4410 194th St Sw Ste A, Lynnwood, WA 98036-5598 | 2020-10-15 |
| 1326646035 | Natasha Habib Dds Ps | Clinic/Center | 1025 153rd St Se Ste 103, Mill Creek, WA 98012-4051 | 2020-10-14 |
| 1386241636 | Mellissa Ilgen, Dds, Pllc | Clinic/Center | 26114 Illinois Ave Ne, Kingston, WA 98346-7674 | 2020-10-08 |
| 1417554932 | Young, Yeung, Lee, Hockin, P.s | Clinic/Center | 2207 2nd Ave, Seattle, WA 98121-2016 | 2020-10-07 |
| 1164039731 | Consolidated Dental Three | Clinic/Center | 19221 108th Ave Se Ste 2, Renton, WA 98055-7369 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.