Provider Demographics
NPI:1215194469
Name:SMILE CONCEPTS
Entity type:Organization
Organization Name:SMILE CONCEPTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PARVATI
Authorized Official - Middle Name:H
Authorized Official - Last Name:IYER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,
Authorized Official - Phone:480-951-2800
Mailing Address - Street 1:13402 N SCOTTSDALE ROAD
Mailing Address - Street 2:SUITE A110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254
Mailing Address - Country:US
Mailing Address - Phone:480-951-2800
Mailing Address - Fax:
Practice Address - Street 1:13402 N SCOTTSDALE RD
Practice Address - Street 2:SUITE A110
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4054
Practice Address - Country:US
Practice Address - Phone:480-951-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ51061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty