Brazos Valley Smile Restorations
Dentist, General Practice in Bryan, TX. Organization (NPI-2).
NPI number1457724353
StatusActive
Last updated in NPPESNov 2, 2015
Details
- NPI
- 1457724353
- Entity type
- Organization (NPI-2)
- Legal business name
- Brazos Valley Smile Restorations
- Organization subpart
- No
- Enumeration date
- Nov 2, 2015
- Last updated
- Nov 2, 2015
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 |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | D22623 | TX | Yes |
Other names
- Smile Restorations (Doing Business As)
Practice location
1615 Barak LnSte 5
Bryan, TX 77802-3315
Phone 979-846-1121 · Fax 979-846-5771
Mailing address
1615 Barak LnSte 5
Bryan, TX 77802-3315
Phone 979-846-1121 · Fax 979-846-5771
Authorized official
Ryan Jouett
President
9798461121
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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