ELEGANT SMILES DENTISTRY NPI 1740629039

NPI Information

NPI: 1740629039
Provider Name: ELEGANT SMILES DENTISTRY
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
4775 KNIGHTS BRIDGE BLVD.
COLUMBUS, OH
ZIP 43214
Phone: (614) 824-5454
Get Directions

ELEGANT SMILES DENTISTRY is a dental clinic center in Columbus, OH. ELEGANT SMILES DENTISTRY NPI is 1740629039. The provider is registered as an organization entity type.

The provider's business location address is:

4775 KNIGHTS BRIDGE BLVD.
COLUMBUS, OH
ZIP 43214
Phone: (614) 824-5454

The provider's authorized official is Ali Khaksarfard .
The authorized official title is Dentist/owner and has the following contact phone number (614) 824-5454.

The enumeration date for this NPI number is 6/19/2013 and was last updated on 6/19/2013.

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
1	261QD0000X	Clinic/Center	Dental	21821	OHIO	Yes

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
1	2417772	MEDICAID	OHIO

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: 11/14/2023

NPI Synchronization or Removal

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