Smile Orthodontics Stillwater, LLC
Dentist, Orthodontics and Dentofacial Orthopedics in Anoka, MN. Organization (NPI-2).
NPI number1457064800
StatusActive
Last updated in NPPESDec 30, 2022
Details
- NPI
- 1457064800
- Entity type
- Organization (NPI-2)
- Legal business name
- Smile Orthodontics Stillwater, LLC
- Organization subpart
- Yes
- Enumeration date
- Dec 30, 2022
- Certification date
- Dec 30, 2022
- Last updated
- Dec 30, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | – | – | Yes |
Other names
- Smile Orthodontics (Doing Business As)
Practice location
2150 3rd Ave Ste 110Anoka, MN 55303-2200
Phone 651-351-7777
Mailing address
1041 Grand Ave # 531Saint Paul, MN 55105-3002
Authorized official
Douglas Wolff
Owner/DDS
6513517777
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