Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Create-A-Smile, PC

Organization Dentist · NPI 1588995229

Create-A-Smile, PC is a Dentist in Bloomington, Indiana. Licensed in Indiana. Registered with an NPI since 2010.

Licensed in
IN
In the registry since
2010
Specialties on file
3
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2815 N Walnut St
Bloomington, IN 47404-2077
Phone: (812) 332-1405
Fax: (812) 332-4331
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 12010311A (IN)
Dentist Taxonomy 122300000X · Licence 12011246A (IN)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X

Record details

NPI number1588995229
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shannon Moore — Owner · (812) 332-1405
NPI enumeratedJanuary 20, 2010
Last updated in NPPESMay 17, 2022
Certification dateMay 17, 2022
Mailing address2815 N Walnut St, Bloomington, IN 47404-2077

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