MEDICARE: SMILE AND AIRWAY HEALTH, 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	174400000X	Specialist

General Provider Information

NPI Number	:	1861351637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMILE AND AIRWAY HEALTH, LLC

Provider Business Mailing Address
First Line	:	5268 SNOW GOOSE ST
Second Line	:
City	:	BRIGHTON
State	:	CO
Zip	:	80601-5344
Country	:	US
Telephone Number	:	720-339-8671
Fax Number	:

Provider Business Practice Location Address
First Line	:	5268 SNOW GOOSE ST
Second Line	:
City	:	BRIGHTON
State	:	CO
Zip	:	80601-5344
Country	:	US
Telephone Number	:	720-339-8671
Fax Number	:

Authorized Official
Title or Position	:	OWNER,CERTIFIED OROFACIAL MYOLOGIST
Name	:	KIMMIE HERRERA
Credential	:
Telephone Number	:	720-339-8671

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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