SMILE DENTAL ASSOCIATES, LLC (NPI# 1356716997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356716997 |
| Entity Type | Organization |
| Organization Name | SMILE DENTAL ASSOCIATES, LLC |
| Practice Address |
1620 E Rollins St Moberly MO 65270-2478 |
| Mailing Address |
Po Box 306 Moberly MO 65270-0306 |
| Practice Telephone | 6602636642 |
| Mailing Telephone | 6602636642 |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2015-12-08 |
| Authorized Official Name | KENT E JOHNSON (PRESIDENT) |
| Authorized Official Telephone | 6602636642 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
2011015034 | MO | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
013322 | MO | Dental Providers |
| Street Address |
1620 E ROLLINS ST |
| City | MOBERLY |
| State | MO |
| Zip Code | 65270-2478 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215221445 | Carl R Liebhart | Dentist | 1620 E Rollins St, Moberly, MO 65270-2478 | 2011-06-06 |
| 1013515675 | Troy A Hutinger Dds PC | Clinic/Center | 1620 E Rollins St, Moberly, MO 65270-2478 | 2020-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538628052 | Thomas Johnston | Physical Therapist | Thrive Physical Therapy, LLC, 417 E Urbandale Drive, Moberly, MO 65270 | 2019-03-14 |
| 1245709682 | Sam's Prescription Shop, Inc. | Durable Medical Equipment & Medical Supplies | 300 N. Morley Street, Moberly, MO 65270 | 2018-11-15 |
| 1639324585 | Trinidad J. Aguilera | General Practice | 5201 South Morley, Moberly, MO 65270 | 2008-11-19 |
| 1023270170 | Jessica Winn | Internal Medicine | 1513 Union Ave Ste 1500, Moberly, MO 65270 | 2008-06-30 |
| 1629237383 | Heather Ann Lavalley | Physical Therapy Assistant | 1346 S Morley, Moberly, MO 65270 | 2008-06-06 |
| 1265602429 | Mckenzie Prescription Center Inc | Hearing Aid Equipment | 643 N Morley St Ste A, Moberly, MO 65270 | 2008-03-04 |
| 1366624165 | Sharon Kay Steele | Military Hospital | 1510 Highway Jj Lot41, Moberly, MO 65270 | 2007-12-04 |
| 1932241536 | Christian S Tadrus | Pharmacist | 530 E. 24 Highway, (26-39586), Moberly, MO 65270 | 2007-02-12 |
| 1588700140 | Heartland Neurology, LLC | Psychiatry & Neurology | 300 N. Morley, Suite H, Moberly, MO 65270 | 2007-01-30 |
| 1164571519 | John James Oloughlin | Dentist | 1616 N Morely, Ste B, Moberly, MO 65270 | 2007-01-08 |
| Find all providers in zip 65270 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457413429 | Daniel R Menze | Dentist | 1013 W Highway 24, Moberly, MO 65270-3156 | 2006-12-15 |
| 1558421248 | Michael Wade Harrod | Dentist | 5201 South Morley St., Moberly, MO 65270 | 2006-12-11 |
| 1497775530 | Michael W Berry | Dentist | 110 E Rollins St, Moberly, MO 65270-2269 | 2006-07-20 |
| 1356653703 | Letrisha Ann Thomas | Dentist | 1013 W Highway 24, Moberly, MO 65270-3156 | 2010-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194322990 | Wildhorse Dental Care, LLC | Dentist | 399 Patriotic Trl, Weldon Spring, MO 63304-7936 | 2020-10-05 |
| 1801493762 | Alexander Ahmadi | Dentist | 4171 Crescent Dr Ste 102, Saint Louis, MO 63129-3645 | 2020-10-05 |
| 1184239832 | Adam Wesley Gadbois | Dentist | 220 Diego Dr, Columbia, MO 65203-4919 | 2020-09-10 |
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1538778592 | Maya Grace Habibi | Dentist | 5212 N Service Rd, Saint Peters, MO 63376-3950 | 2020-07-27 |
| 1427667500 | Breakthrough Dental Partners LLC | Dentist | 401 E Mechanic St, Harrisonville, MO 64701-2427 | 2020-07-24 |
| 1396353876 | Michael Rehme Jr. | Dentist | 2821 N Ballas Rd Ste 245, Saint Louis, MO 63131-2378 | 2020-07-21 |
| 1790303774 | Wed Khizirpour | Dentist | 1680 Nw Chipman Rd, Lees Summit, MO 64081-3934 | 2020-07-07 |
| 1275150716 | Hills Dentistry LLC | Dentist | 2000 Kentucky Ave Ste C, Platte City, MO 64079-7714 | 2020-07-01 |
| 1134745227 | Kayla White | Dentist | 1401 Forum Blvd Ste 203, Columbia, MO 65203-1915 | 2020-06-24 |
| 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.