MISSOURI SMILES LLC NPI 1508549130

NPI Information

  • NPI: 1508549130
  • Provider Name: MISSOURI SMILES LLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 3621 DISCOVERY PARKWAY
    STE 101
    COLUMBIA, MO
    ZIP 65201
  • Phone: (573) 424-2067

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NPI Details

MISSOURI SMILES LLC is a dental clinic center in Columbia, MO. MISSOURI SMILES LLC NPI is 1508549130. The provider is registered as an organization entity type.

The provider's business location address is:

3621 DISCOVERY PARKWAY
STE 101
COLUMBIA, MO
ZIP 65201
Phone: (573) 424-2067

The provider's authorized official is Kyle Lisenby .
The authorized official title is Dentist Owner and has the following contact phone number (573) 424-2067.

The enumeration date for this NPI number is 8/10/2023 and was last updated on 8/10/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD0000XClinic/CenterDentalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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