IDEALSMILE NPI 1710130455

NPI Information

  • NPI: 1710130455
  • Provider Name: IDEALSMILE
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 2501 WHITTLESEY BLVD
    SUITE B
    COLUMBUS, GA
    ZIP 31909
  • Phone: (706) 257-7374

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NPI Details

IDEALSMILE is a dental clinic center in Columbus, GA. IDEALSMILE NPI is 1710130455. The provider is registered as an organization entity type.

The provider's business location address is:

2501 WHITTLESEY BLVD
SUITE B
COLUMBUS, GA
ZIP 31909-031
Phone: (706) 257-7374
Fax: (706) 257-7379

The provider's authorized official is Jae H Ham .
The authorized official title is President and has the following contact phone number (706) 257-7374.

The enumeration date for this NPI number is 10/28/2008 and was last updated on 10/28/2008.

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/CenterDentalDN013040GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1561235509CMEDICAIDGEORGIA
2626075029CMEDICAIDGEORGIA

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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