MEDICARE: SMILE CENTER OF EDINBURG, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1598602526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMILE CENTER OF EDINBURG, PLLC

Provider Business Mailing Address
First Line	:	7510 WOOLDRIDGE RD APT 9019
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-2873
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3419 S ALAMO RD
Second Line	:	SUITE A
City	:	EDINBURG
State	:	TX
Zip	:	78542
Country	:	US
Telephone Number	:	956-997-4777
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. PENG-HAN LI
Credential	:
Telephone Number	:	909-907-9788

Provider Enumeration Date	:	04/29/2026
Last Update Date	:	05/13/2026

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