MEDICARE: SMOOTH DENTISTRY

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	122300000X	Dentist	6138	NV

General Provider Information

NPI Number	:	1497114151
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMOOTH DENTISTRY

Provider Business Mailing Address
First Line	:	7060 S DURANGO DR STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2023
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7060 S DURANGO DR
Second Line	:	STE 110
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2023
Country	:	US
Telephone Number	:	510-673-5604
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LYNH CHON
Credential	:	D.D.S.
Telephone Number	:	510-673-5604

Provider Enumeration Date	:	02/23/2016
Last Update Date	:	02/23/2016

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Directions to “SMOOTH DENTISTRY ” Practice Location

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