CUSTOM SMILE LLC - NPI 1710148663

Q: What is Custom Smile LLC's NPI number?

The NPI number for Custom Smile LLC is 1710148663. It was assigned to this organization in the NPPES registry on June 23, 2008.

Q: What is Custom Smile LLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Custom Smile LLC was last updated on July 8, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Custom Smile Llc NPPES

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

CUSTOM SMILE LLC (NPI 1710148663) is a healthcare organization registered as a dentist in Mesa, Arizona and active in the NPI registry since June 2008. The organization lists Stan L Covington, Dentist, as its authorized official.

NPPES Registry Identity

NPI1710148663

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameCUSTOM SMILE LLC

Location Address2919 S ELLSWORTH RD, SUITE 141Mesa, AZ 85212-2164

Mailing Address2919 S Ellsworth Rd, Suite 141Mesa, AZ 85212-2164 · (480) 307-8430 · Fax (480) 307-8431

Phone(480) 307-8430

Fax(480) 307-8431

Organization SubpartNo

Authorized OfficialStan L CovingtonDentist · (480) 307-8430

Enumeration DateJune 23, 2008

Last NPPES UpdateJuly 8, 2008

✔ NPI 1710148663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in AZ · 4675

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

2919 S ELLSWORTH RD, Mesa, AZ 85212

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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