MEDICARE: SMILE MORE DENTURES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122400000X	Denturist

General Provider Information

NPI Number	:	1316806243
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMILE MORE DENTURES LLC

Provider Business Mailing Address
First Line	:	3916 MAIN ST # 102
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98663-1844
Country	:	US
Telephone Number	:	360-524-2004
Fax Number	:	360-200-5206

Provider Business Practice Location Address
First Line	:	3916 MAIN ST # 102
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98663-1844
Country	:	US
Telephone Number	:	360-524-2004
Fax Number	:	360-200-5206

Authorized Official
Title or Position	:	DENTURIST
Name	:	PAVEL NYUKEYEV
Credential	:	LD
Telephone Number	:	360-524-2004

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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Directions to “SMILE MORE DENTURES LLC ” Practice Location

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