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General NPI Number Information
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NPI Number | 1104152578
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Entity Type | Organization
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Legal Business Name | BIG SMILES KENTUCKY PSC
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Dates
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Enumeration Date | 10/20/2009
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 424 LEWIS HARGETT CIR STE 250
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City | LEXINGTON
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State | KY
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Zip | 40503-3687
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Country | US
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Telephone | 888-833-8441
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Fax | 888-373-9612
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Provider Business Mailing Address
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Address Line | 2550 W UNION HILLS DR SUITE 202
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City | PHOENIX
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State | AZ
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Zip | 85027-5163
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Country | US
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Telephone | 877-227-9892
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Fax | 623-321-6268
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Authorized Official
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Title or Position | OWNER
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Name | ELLIOT SCHLANG
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Credential |
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Telephone | 877-227-9892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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