Mountain Smiles, PLLC

Dentist · Lacey, WA

Organization Active NPI

NPI number 1083410237

Practice location

8765 Tallon Ln NE # 1
Lacey, WA 98516-6654
Phone
(360) 577-0566

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NPI record

NPI
1083410237
Entity type
Organization (Type 2)
Enumeration date
February 19, 2025
Last updated
February 27, 2025
Certified
February 27, 2025
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X — —
Dental Anesthesiology 1223D0004X — —
Endodontics 1223E0200X — —
General Practice Dentistry 1223G0001X — —
Periodontics 1223P0300X — —
Prosthodontics 1223P0700X — —
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X — —
Denturist 122400000X — —
Dental Hygienist 124Q00000X — —
Dental Assistant 126800000X — —

Authorized official

Name
Angel Gimenez
Title
Credentialing Manager
Phone
(719) 300-5933

About Mountain Smiles, PLLC

Mountain Smiles, PLLC is a healthcare organization registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 8765 Tallon Ln NE # 1, Lacey, WA 98516-6654. The NPI number 1083410237 was assigned on February 19, 2025 and the record was last updated on February 27, 2025.

The authorized official for this organization is Angel Gimenez, Credentialing Manager.

Frequently asked questions

What is the NPI number of Mountain Smiles, PLLC?

The NPI number is 1083410237.

What is the phone number of Mountain Smiles, PLLC?

The phone number listed for the practice location is (360) 577-0566.

Where is Mountain Smiles, PLLC located?

8765 Tallon Ln NE # 1, Lacey, WA 98516-6654.

What is the taxonomy code for Mountain Smiles, PLLC?

The primary taxonomy code is 122300000X – Dentist; 9 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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