Healthcare Provider Details

I. General information

NPI: 1780928564
Provider Name (Legal Business Name): CARE SMILES ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2012
Last Update Date: 11/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 S FEDERAL BLVD BUILDING C
DENVER CO
80219-5501
US

IV. Provider business mailing address

1344 S CHAMBERS RD SUITE 104
AURORA CO
80017-4096
US

V. Phone/Fax

Practice location:
  • Phone: 303-337-2999
  • Fax:
Mailing address:
  • Phone: 303-337-2999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number9021
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number10242
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number9021
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10242
License Number StateCO
# 5
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number9021
License Number StateCO
# 6
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number9021
License Number StateCO

VIII. Authorized Official

Name: HOANG NGUYEN
Title or Position: PRESIDENT
Credential:
Phone: 303-652-7632