# CREATING NEW SMILES ASC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Creating New Smiles, ASC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124913561
- **Authorized official:** DR. JIM ERVIL DDS (OWNER)
- **Authorized official phone:** (804) 615-9682

## Contact information

- **Practice address:** 1682 CHURCH ST, NORFOLK, VA 23504-2346
- **Practice address phone:** (757) 683-0143
- **Practice address fax:** (757) 901-0613
- **Mailing address:** 4936 LIMESTONE AVE, VIRGINIA BEACH, VA 23462-4430

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0004X | Dental Anesthesiology | — | NULL | — |
| 1223D0004X | Dental Anesthesiology | — | — | — |
| 1223P0221X | Pediatric Dentistry | — | NULL | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/09/2025
- **Last updated:** 06/09/2025