Healthcare Provider Details

I. General information

NPI: 1841905148
Provider Name (Legal Business Name): SOMETHING TO SMILE ABOUT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2023
Last Update Date: 01/21/2023
Certification Date: 01/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12670 COMETA AVE
SAN FERNANDO CA
91340-1148
US

IV. Provider business mailing address

12670 COMETA AVE
SAN FERNANDO CA
91340-1148
US

V. Phone/Fax

Practice location:
  • Phone: 818-571-5338
  • Fax:
Mailing address:
  • Phone: 818-571-5338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH HERMOSILLO
Title or Position: OWNER
Credential: RDHAP, RDH
Phone: 818-571-5338