Provider Demographics
NPI:1679313076
Name:PEARLAND SMILES PLLC
Entity type:Organization
Organization Name:PEARLAND SMILES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YASAS
Authorized Official - Middle Name:SHRI NALAKA
Authorized Official - Last Name:JAYARATNE
Authorized Official - Suffix:
Authorized Official - Credentials:BDS, MDS, PHD
Authorized Official - Phone:857-488-3009
Mailing Address - Street 1:11021 SHADOW CREEK PKWY STE 108
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7401
Mailing Address - Country:US
Mailing Address - Phone:281-241-1411
Mailing Address - Fax:
Practice Address - Street 1:11021 SHADOW CREEK PKWY STE 108
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7401
Practice Address - Country:US
Practice Address - Phone:281-241-1411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty