NPI Code Detail JSON Logo

1316691272 NPI number — ROCKIN SMILES DENTAL PLLC

NPI Number: 1316691272
Health Care Provider/Practitioner: ROCKIN SMILES DENTAL PLLC

Information about “1316691272” NPI (ROCKIN SMILES DENTAL PLLC) exists in 1316691272 in HTML format HTML  |  1316691272 in plain Text format TXT  |  1316691272 in PDF (Portable Document Format) PDF  |  1316691272 in an XML format XML  formats.

NPI Number : 1316691272 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1316691272",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ROCKIN SMILES DENTAL PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1156 BUFFALO VALLEY RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COOKEVILLE",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "38501-4463",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "801-259-1833",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "154 E BOCKMAN WAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SPARTA",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "38583-2036",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "931-488-8544",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/09/2022",
    "LastUpdateDate": "03/15/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "GRAVES",
    "AuthorizedOfficialFirstName": "MICHELLE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OFFICE MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "931-488-8544",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1223X0400X",
          "TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223G0001X",
          "TaxonomyName": "General Practice Dentistry",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223P0221X",
          "TaxonomyName": "Pediatric Dentistry",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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