GREAT SMILES DENTAL CARE (NPI# 1629554167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629554167 |
| Entity Type | Organization |
| Organization Name | GREAT SMILES DENTAL CARE |
| Practice Address |
14800 W. Mountain View Blvd Suite 200 Surprise AZ 85574 |
| Practice Telephone | 6239335749 |
| Practice Fax Number | 6238151220 |
| Mailing Telephone | 6239335749 |
| Mailing Fax Number | 6238151220 |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2018-07-18 |
| Authorized Official Name | DR. ERIC PAUL WENDELSCHAFER (DENTIST) |
| Authorized Official Telephone | 4806062630 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | B13724222 | AZ | Dental Providers |
| Street Address |
14800 W. MOUNTAIN VIEW BLVD SUITE 200 |
| City | SURPRISE |
| State | AZ |
| Zip Code | 85574 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588967 | Suzanne Basco | Counselor | 27072 N 175th Dr, Surprise, AZ 85387-1094 | 2020-11-04 |
| 1932709656 | Samantha Ashlee Wirth | Registered Nurse | 16316 N Lasso Dr, Surprise, AZ 85374-5445 | 2020-10-30 |
| 1619576436 | Meagan Tanner | Doula | 14152 W Surrey Dr, Surprise, AZ 85379-6640 | 2020-10-22 |
| 1104425123 | Erin Jean Mcmanus-tomanek | Nurse Practitioner | 12851 N 142nd Ave, Surprise, AZ 85379-9502 | 2020-10-21 |
| 1477152361 | Jennifer L St. Clair | Counselor | 12211 W Bell Rd Ste 205, Surprise, AZ 85378-9522 | 2020-10-21 |
| 1679171151 | Diana Kim | Dentist | 15128 W Bell Rd Ste 12, Surprise, AZ 85374-2451 | 2020-10-15 |
| 1689272734 | Tricia J Milonas | Massage Therapist | 15027 W Bell Rd Ste 100, Surprise, AZ 85374-3256 | 2020-10-12 |
| 1154928463 | Willie Sellers | Nurse Practitioner | 15354 W Charter Oak Rd, Surprise, AZ 85379-9184 | 2020-10-08 |
| 1205433844 | Angelic Care LLC | Assisted Living Facility | 15247 W Wethersfield Rd, Surprise, AZ 85379-9177 | 2020-10-07 |
| 1720685241 | Paige Marie Walberg | Specialist/Technologist | 16629 N Greasewood St Apt 139, Surprise, AZ 85378-3686 | 2020-10-07 |
| Find all providers in SURPRISE | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891346003 | Abdullah Ahmad | Dentist | 13820 W Bell Rd Ste 5, Surprise, AZ 85374-3991 | 2019-09-28 |
| 1508410887 | Kids Dentists of Surprise and Orthodontics, LLP | Dentist | 15180 N. Cotton Lane, Suite 104, Surprise, AZ 85388 | 2019-07-25 |
| 1649766452 | Keeley Nga Le | Dentist | 17081 W Greenway Rd Ste 120, Surprise, AZ 85388-9612 | 2018-07-04 |
| 1538653936 | Erin Balaban | Dentist | 15317 W Bell Rd Suite 108, Surprise, AZ 85374-4509 | 2018-06-19 |
| 1790139749 | Timothy Scott Paulson Jr. | Dentist | 15229 W Elko Dr, Surprise, AZ 85374-4469 | 2016-04-15 |
| 1679933154 | Surprise Family Dentistry | Dentist | 18775 N Reems Rd Ste 300, Surprise, AZ 85374-8647 | 2016-02-26 |
| 1811373350 | Jessica Brereton Peterkin | Dentist | 13856 W Waddell Rd Ste 102, Surprise, AZ 85379-3801 | 2015-08-06 |
| 1447649454 | Jose E Delos Santos | Dentist | 15717 W Jenan Dr, Surprise, AZ 85379-1026 | 2015-01-14 |
| 1104231562 | Zachary Martineau | Dentist | 15341 W Waddell Rd Ste B107, Surprise, AZ 85379-5169 | 2014-06-24 |
| 1164860755 | Nicholas Stephen Netzel | Dentist | 15294 N Brookside Ln, Surprise, AZ 85374 | 2013-06-05 |
| Find all providers in SURPRISE | ||||
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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.