Organization
THE SMILE STARTER
Active
Other names
The Smile Starter
Organization subpart
No
Provider details
NPI number
Authorized official
NDIDI UKA DDS (CEO)
(310) 926-3570
Entity
Organization
Contact information
Practice address
2047 W MANCHESTER AVE, LOS ANGELES, CA 90047-2926
(310) 926-3570
Mailing address
3756 SANTA ROSALIA DR STE 517, LOS ANGELES, CA 90008-3656
(310) 926-3570
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QD0000X
Dental Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
11/30/2024
Last updated
11/30/2024
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