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Contact Information

LITTLE SMILES OF SURPRISE
13915 N DYSART RD
STE A1
EL MIRAGE, AZ85335
 Phone: 623-444-6340
 Fax: 623-444-6350
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for LITTLE SMILES OF SURPRISE · (Female)

NPI Number 1134181332
Status Active
Credentials
Entity Individual
Enumeration date 04/04/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • AZ License # D5287
  • AZ Medicaid 611922
  • Other 000870541001 UNITED CONCORDIA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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