Provider Demographics
NPI:1588269542
Name:BEAUTIFUL SMILEZ INC
Entity type:Organization
Organization Name:BEAUTIFUL SMILEZ INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGIONAL
Authorized Official - Prefix:MS
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARMENDAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-633-6620
Mailing Address - Street 1:1444 W BETHANY HOME RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-1624
Mailing Address - Country:US
Mailing Address - Phone:602-633-6620
Mailing Address - Fax:602-633-6625
Practice Address - Street 1:1444 W BETHANY HOME RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-1624
Practice Address - Country:US
Practice Address - Phone:602-633-6620
Practice Address - Fax:602-633-6625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental