NPI Code Detail JSON Logo

1649059387 NPI number — PRESTIGE SMILES

NPI Number: 1649059387
Health Care Provider/Practitioner: PRESTIGE SMILES

Information about “1649059387” NPI (PRESTIGE SMILES) exists in 1649059387 in HTML format HTML  |  1649059387 in plain Text format TXT  |  1649059387 in PDF (Portable Document Format) PDF  |  1649059387 in an XML format XML  formats.

NPI Number : 1649059387 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1649059387",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PRESTIGE SMILES",
    "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": "218 E 800 S",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "OREM",
    "MailingAddressStateName": "UT",
    "MailingAddressPostalCode": "84058-5008",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "801-610-7283",
    "MailingAddressFaxNumber": "801-225-2537",
    "FirstLinePracticeLocationAddress": "218 E 800 S",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "OREM",
    "PracticeLocationAddressStateName": "UT",
    "PracticeLocationAddressPostalCode": "84058-5008",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "801-610-7283",
    "PracticeLocationAddressFaxNumber": "801-225-2537",
    "EnumerationDate": "09/22/2023",
    "LastUpdateDate": "09/26/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "FORAKIS",
    "AuthorizedOfficialFirstName": "KIRT",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "801-610-7283",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QD0000X",
        "TaxonomyName": "Dental Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.