OrganizationActive
Custom Smile LLC
NPI 1710148663 · Dentist · Mesa, AZ
Custom Smile LLC is a Dentist organization in Mesa, AZ (NPI 1710148663).
Provider details
- NPI number
- 1710148663
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Stan Covington, Dentist(480) 307-8430
- License
- 4675 (AZ)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 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
2919 S Ellsworth Rd
Suite 141
Mesa, AZ 85212-2164
Phone: (480) 307-8430
Fax: (480) 307-8431
Street-level locationGet directions
Mailing address
2919 S Ellsworth Rd
Mesa, AZ 85212-2164
Registry dates
- Enumerated
- 2008-06-23
- Last updated
- 2008-07-08
Frequently asked questions
- What is Custom Smile LLC's NPI number?
- Custom Smile LLC's National Provider Identifier (NPI) is 1710148663, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Custom Smile LLC?
- Custom Smile LLC is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Custom Smile LLC located?
- Custom Smile LLC's practice location on file with NPPES is 2919 S Ellsworth Rd, Mesa, AZ 85212-2164.
- What is Custom Smile LLC's phone number?
- The practice phone number listed in the NPPES registry for Custom Smile LLC is (480) 307-8430.
- Who is the authorized official for Custom Smile LLC?
- The authorized official listed on Custom Smile LLC's NPPES record is Stan Covington, Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Custom Smile LLC's NPI active?
- Yes — Custom Smile LLC's NPI (1710148663) is active in the NPPES registry as of the last update on 2008-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.