SMILE COUNTRY ORTHODONTICS (NPI# 1356862445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356862445 |
| Entity Type | Organization |
| Organization Name | SMILE COUNTRY ORTHODONTICS |
| Practice Address |
15465 Oak Ln Gulfport MS 39503-2663 |
| Mailing Address |
15465 Oak Ln Ste 100h Gulfport MS 39503-2663 |
| Practice Telephone | 2288324450 |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2017-06-29 |
| Authorized Official Name | KIMBERLY CHELETTE (INSURANCE COORDINATOR) |
| Authorized Official Telephone | 9858931044 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
3502-09 | MS | Dental Providers |
| Street Address |
15465 OAK LN |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-2663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295722965 | Michael E. Zakaras | Psychologist | 15465 Oak Ln, Gulfport, MS 39503-2663 | 2005-09-28 |
| 1023549219 | Children's International, LLC | Clinic/Center | 15465 Oak Ln, Gulfport, MS 39503-2663 | 2017-03-21 |
| 1326489345 | Edward Victor Brown IIi | Dentist | 15465 Oak Ln, Suite 100h, Gulfport, MS 39503-2663 | 2013-07-08 |
| 1043550304 | Lauren Suzanne Zakaras | Social Worker | 15465 Oak Ln, Ste. D, Gulfport, MS 39503-2663 | 2013-02-25 |
| 1285958868 | Dewitt Chiropractic, Pllc | Chiropractor | 15465 Oak Ln, Suite 100b, Gulfport, MS 39503-2663 | 2010-03-25 |
| 1790974111 | Children's Medical Center | Pediatrics | 15465 Oak Ln, Suite 100 F, Gulfport, MS 39503-2663 | 2007-10-22 |
| 1669566881 | Joseph A Rogers | Chiropractor | 15465 Oak Ln, Suite 100b, Gulfport, MS 39503-2663 | 2006-10-03 |
| 1043321318 | Children's Center of Gulfport, Inc. | Pediatrics | 15465 Oak Ln, Suite 100-f, Gulfport, MS 39503-2663 | 2006-08-31 |
| 1841301116 | Fauzia F. Quddus | Pediatrics | 15465 Oak Ln, Suite 100-f, Gulfport, MS 39503-2663 | 2006-08-31 |
| 1043254345 | Patsy H Zakaras | Psychologist | 15465 Oak Ln, Ste. D., Gulfport, MS 39503-2663 | 2006-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013515451 | Gulf Coast Neurospa, LLC | Psychiatry & Neurology | 8845 Lorraine Road, Gulfport, MS 39503 | 2020-10-16 |
| 1447865985 | Nicholas Wyrosdick | Physical Therapist | 12261 Us 49 #1, Gulfport, MS 39503 | 2020-09-11 |
| 1750935169 | Ladner Roy Drugs, LLC. | Pharmacy | 12261 Us 49 Suite 16, Gulfport, MS 39503 | 2019-07-25 |
| 1528559440 | Alexander Therapy Services, LLC | Clinic/Center | 15465 Oak Ln Ste 100c, Gulfport, MS 39503 | 2018-05-25 |
| 1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
| 1083101216 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15094 County Barn Road, Gulfport, MS 39503 | 2018-04-13 |
| 1306343173 | Dr. Raymond Monsour Scurfield, LLC | Community/Behavioral Health | 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 | 2018-04-09 |
| 1952817157 | Mary Beth Welch | Behavioral Analyst | 9230 Old Lorraine Rd, Gulfport, MS 39503 | 2017-12-26 |
| 1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
| 1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
| Find all providers in zip 39503 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598212623 | Edward Victor Brown Jr. | Dentist | 15465 Oak Lane, Gulfport, MS 39564 | 2016-09-07 |
| 1578901815 | Ashley Marie Lestrade | Dentist | 545 16th St, Gulfport, MS 39507-1209 | 2013-06-10 |
| 1538328836 | Michael O. Williams Dds.pa | Dentist | 424 Courthouse Rd, Gulfport, MS 39507-1849 | 2008-06-03 |
| 1174792022 | Bruce Thompson Bleil | Dentist | 15465 Oak Lane, Ste. 100 - H, Gulfport, MS 39503-3524 | 2008-02-25 |
| 1013105451 | Michael Owen Williams | Dentist | 424 Court House Road, Gulfport, MS 39507-1849 | 2007-10-11 |
| 1073643789 | Christopher P Frigo | Dentist | 382 Courthouse Rd Ste C, Gulfport, MS 39507-1864 | 2007-03-06 |
| 1689084964 | Devereux & Nguyen Gulfport Pllc | Dentist | 411 Security Sq, Gulfport, MS 39507-1922 | 2014-05-07 |
| 1326489345 | Edward Victor Brown IIi | Dentist | 15465 Oak Ln, Suite 100h, Gulfport, MS 39503-2663 | 2013-07-08 |
| 1710268669 | Michael O. Williams, D.d.s.,p.a. | Dentist | 424 Courthouse Rd, Gulfport, MS 39507-1849 | 2011-09-06 |
| 1750508479 | John S. Clark, Apdc | Dentist | 411 Security Sq, Gulfport, MS 39507-1922 | 2007-04-20 |
| Find all providers in GULFPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.