NPIMap

Organization Active NPI

Smith Dental West

Doing business as BarkRiver Dental Group

  • General Practice Dentistry
  • Hartland, WI
National Provider Identifier
1003936279
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SMITH DENTAL WEST
Doing business as
BarkRiver Dental Group
Practice address
625 Walnut Ridge Dr - Suite #102
Hartland, WI 53029-8894
Phone
(262) 367-4255
Fax
(262) 367-4714
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Daniel P. Smith, DDS
Title
Dentist/Owner
Phone
(262) 367-4255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

625 Walnut Ridge Dr - Suite #102
Hartland, WI 53029-8894

Mailing address

625 Walnut Ridge Dr - Suite #102
Hartland, WI 53029-8894
Phone (262) 367-4255

Other names 1

  • BarkRiver Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

625 Walnut Ridge Dr
Hartland, WI 53029

625 Walnut Ridge Dr
Ste 102
Hartland, WI 53029
Phone (262) 367-4255

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1003936279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 WALNUT RIDGE DR - SUITE #102",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530298894",
            "telephone_number": "262-367-4255",
            "fax_number": "262-367-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 WALNUT RIDGE DR - SUITE #102",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530298894",
            "telephone_number": "262-367-4255",
            "fax_number": "262-367-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH DENTAL WEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "262-367-4255",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BarkRiver Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hartland, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.