Healthcare Provider Details

I. General information

NPI: 1376475814
Provider Name (Legal Business Name): ALL SMILES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 LARCK CREST LN
WINSTON SALEM NC
27107-8205
US

IV. Provider business mailing address

13006 HERITAGE S
WARREN MI
48089-2089
US

V. Phone/Fax

Practice location:
  • Phone: 313-979-5537
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MONIKE THOMAS
Title or Position: OWNER
Credential:
Phone: 313-979-5537