THE SMILE STORE
NPI 1518505692
Dentist - Orthodontics and Dentofacial Orthopedics in Palm Beach Gardens, FL

Active since December 19, 2019
4362 NORTHLAKE BLVD STE 114, PALM BEACH GARDENS, FL 33410(561) 658-4100 Get Directions Write a Review

NPPES record last updated: June 2, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 2, 2021, Sep 23, 2020, Aug 14, 2020 and 2 more (5 updates tracked since 2019).

About The Smile Store NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE SMILE STORE (NPI 1518505692) is a healthcare organization registered as an orthodontics and dentofacial orthopedics in Palm Beach Gardens, Florida and active in the NPI registry since December 2019. The organization lists Brenda Cooper, Insurance Coordinator, as its authorized official.

NPPES Registry Identity

NPI1518505692
Entity TypeOrganization
Primary Taxonomy1223X0400X
Legal Business NamePALM BEACH GARDENS ORTHO LOCATION LLC
Location Address4362 NORTHLAKE BLVD STE 114Palm Beach Gardens, FL 33410-6269
Mailing Address4362 Northlake Blvd Ste 114Palm Beach Gardens, FL 33410-6269 · (561) 658-4100 · Fax (866) 333-2309
Organization SubpartYesParent: Charleston Orthodontic Specialists, Inc
Authorized OfficialBrenda CooperInsurance Coordinator · (561) 658-4100
Enumeration DateDecember 19, 2019
Last NPPES UpdateJune 2, 20215 updates tracked since enumeration
NPPES CertifiedJune 2, 2021
NPI 1518505692 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Orthodontics and Dentofacial OrthopedicsDental Providers
Taxonomy Code1223X0400X
Definition

That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.

4362 NORTHLAKE BLVD STE 114, Palm Beach Gardens, FL 33410

Other Names 1

Doing Business AsThe Smile Store

Other Identifiers 1

Medicaid105737100FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (Orthodontics and Dentofacial Orthopedics)
4362 NORTHLAKE BLVD STE 114
PALM BEACH GARDENS, FL 33410
Dentist (Orthodontics and Dentofacial Orthopedics)
4362 NORTHLAKE BLVD STE 114
PALM BEACH GARDENS, FL 33410

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Palm Beach Gardens Ortho Location LLC's NPI number?

The NPI number for Palm Beach Gardens Ortho Location LLC is 1518505692. It was assigned to this organization in the NPPES registry on December 19, 2019. The provider is doing business as The Smile Store.

Where is Palm Beach Gardens Ortho Location LLC located?

Palm Beach Gardens Ortho Location LLC is located at 4362 Northlake Blvd Ste 114, Palm Beach Gardens, FL 33410. The listed phone number is (561) 658-4100.

What is Palm Beach Gardens Ortho Location LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orthodontics and Dentofacial Orthopedics, with taxonomy code 1223X0400X.

When was this NPI record last updated?

The NPPES record for Palm Beach Gardens Ortho Location LLC was last updated on June 2, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.