Great Smiles Dental Care

Dentist in Surprise, AZ. Organization (NPI-2).

NPI number1629554167

StatusActive

Last updated in NPPESJul 18, 2018

Details

NPI: 1629554167
Entity type: Organization (NPI-2)
Legal business name: Great Smiles Dental Care
Organization subpart: No
Enumeration date: Jul 18, 2018
Last updated: Jul 18, 2018

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
122300000X	Dentist	B13724222	AZ	Yes

Practice location

14800 W. Mountain View Blvd
Suite 200
Surprise, AZ 85574

Phone 623-933-5749 · Fax 623-815-1220

Mailing address

14800 W. Mountain View Blvd
Suite 200
Surprise, AZ 85574

Phone 623-933-5749 · Fax 623-815-1220

Authorized official

Eric Paul Wendelschafer
Dentist
4806062630

Is something wrong?

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Other Dentist providers in Surprise, AZ

All 53 Dentist providers in Surprise · All 3,078 providers in Surprise

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