REAL SMILES (NPI# 1649447236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649447236 |
| Entity Type | Organization |
| Organization Name | REAL SMILES |
| Practice Address |
3330 Mansfield Hwy Ste B Fort Worth TX 76119 |
| Mailing Address |
3839 Mckinney Ave Apt 403 Dallas TX 75204-1417 |
| Practice Telephone | 8186539799 |
| Mailing Telephone | 8186539799 |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-05-13 |
| Authorized Official Name | DR. RAFFY KOUYOUMDJIAN (CEO) |
| Authorized Official Telephone | 8186539799 |
| Authorized Official Credential | D.M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 23066 | TX | Dental Providers |
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
| Y | 1223G0001X |
Dentist Specialization: General Practice |
23066 | TX | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | REAL SMILES LLC | 151 Lakeview Avenue, Rockville Centre, Ny 11570 |
| Street Address |
3330 MANSFIELD HWY STE B |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467003111 | Asha Jamilia Robertson | Technician | 5321 Rita Kay Ln Lot #21, Fort Worth, TX 76119 | 2019-09-24 |
| 1801366406 | Gina Stovall | Behavioral Analyst | 1100 Circle Drive Suite 101, Fort Worth, TX 76119 | 2018-11-27 |
| 1730660374 | Lisa Alfaro Williams | Counselor | 3120, 22, 24 S.e. Loop 820, Fort Worth, TX 76119 | 2018-08-22 |
| 1023597366 | Gregoire M Butera | Registered Nurse | 3883 Mighty Mite Dr., Fort Worth, TX 76119 | 2018-08-08 |
| 1598244816 | Tawnya R Anderson | Registered Nurse | 3883 Mighty Mite Drive, Fort Worth, TX 76119 | 2018-08-08 |
| 1730699802 | Miller Dental Pllc | Dentist | 3307 Miller Ave Suite #a, Fort Worth, TX 76119 | 2017-10-03 |
| 1053853697 | Carla Walter | Community Health Worker | 4125 Hardeman Ave, Fort Worth, TX 76119 | 2016-11-14 |
| 1710238134 | Thuy Vy Phan | Physician Assistant | 2500 Circle Dr, Fort Worth, TX 76119 | 2012-09-25 |
| 1598031841 | Candace Frances Been | Podiatrist | Federal Bureau of Prisons Federal Medical Center Fort, 3150 Horton Road, Fort Worth, TX 76119 | 2012-03-30 |
| 1053600262 | Miller Dental | Dentist | 3307 Miller Ave Suite A, Fort Worth, TX 76119 | 2011-03-29 |
| Find all providers in zip 76119 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899226 | Calvin Eastwood Dds Pllc | Dentist | 3088 Basswood Blvd # 150, Fort Worth, TX 76137-1676 | 2020-10-18 |
| 1205440146 | Ismile Dental At The Chisolm Trail Pllc | Dentist | 5513 Sycamore School Rd, Fort Worth, TX 76123 | 2020-09-08 |
| 1770118911 | Dentists At Chisholm Trail, PC | Dentist | 9604 Ten Gallon Dr, Fort Worth, TX 76123-2186 | 2020-03-09 |
| 1821620121 | Eastchase Mighty Pllc | Dentist | 8430 East Fwy # 115, Fort Worth, TX 76120-4428 | 2020-02-05 |
| 1629628532 | Today Dental of Saginaw Pllc | Dentist | 1628 Basswood Blvd, Fort Worth, TX 76244 | 2019-09-13 |
| 1225685449 | Cody Brown Dds Pllc | Dentist | 2701 W Heritage Trace Pkwy, Ste 130, Fort Worth, TX 76177 | 2019-08-22 |
| 1558916361 | Nimu Pllc | Dentist | 5325 Mcpherson Blvd, Suite 120, Fort Worth, TX 76123 | 2019-08-08 |
| 1730733171 | Andrea Uglem | Dentist | 2700 Horne St Ste 120, Fort Worth, TX 76107-4604 | 2019-07-24 |
| 1790338325 | Mint Dentistry Pllc | Dentist | 3901 West Fwy Ste 113, Fort Worth, TX 76107-5654 | 2019-07-23 |
| 1124671094 | Emily Jane Creighton | Dentist | 1100 S Lake St, Fort Worth, TX 76104-4374 | 2019-07-19 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76119 |
Please comment or provide details below to improve the information on REAL SMILES.
| 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.