OrganizationActive
Create-A-Smile, PC
NPI 1588995229 · Dentist · Bloomington, IN
Create-A-Smile, PC is a Dentist organization in Bloomington, IN (NPI 1588995229).
Provider details
- NPI number
- 1588995229
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Shannon Moore, Owner(812) 332-1405
- License
- 12011246A (IN)
Specialties & taxonomies
Dental Providers
Dental Providers
Suppliers
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2815 N Walnut St
Bloomington, IN 47404-2077
Phone: (812) 332-1405
Fax: (812) 332-4331
Street-level locationGet directions
Mailing address
2815 N Walnut St
Bloomington, IN 47404-2077
Registry dates
- Enumerated
- 2010-01-20
- Last updated
- 2022-05-17
- Certified
- 2022-05-17
Frequently asked questions
- What is Create-A-Smile, PC's NPI number?
- Create-A-Smile, PC's National Provider Identifier (NPI) is 1588995229, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Create-A-Smile, PC?
- Create-A-Smile, PC is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Create-A-Smile, PC located?
- Create-A-Smile, PC's practice location on file with NPPES is 2815 N Walnut St, Bloomington, IN 47404-2077.
- What is Create-A-Smile, PC's phone number?
- The practice phone number listed in the NPPES registry for Create-A-Smile, PC is (812) 332-1405.
- Who is the authorized official for Create-A-Smile, PC?
- The authorized official listed on Create-A-Smile, PC's NPPES record is Shannon Moore, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Create-A-Smile, PC's NPI active?
- Yes — Create-A-Smile, PC's NPI (1588995229) is active in the NPPES registry as of the last update on 2022-05-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.