Samuel G. Smith, D.M.D.,M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D-3549-OR Issued in ID

Practice address

1541 S. Times Square
Boise, ID 83709

Phone

(208) 321-7006

Fax

(208) 375-4647

NPI assigned

Aug 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Id SDS II PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Boise, ID
  • NPI 1538909379
  NPD (past)
• Id SDS II PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Pocatello, ID
  • NPI 1861265647
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013920313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 S. TIMES SQUARE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709",
            "telephone_number": "208-321-7006",
            "fax_number": "208-375-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 S. TIMES SQUARE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709",
            "telephone_number": "208-321-7006",
            "fax_number": "208-375-4647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SAMUEL",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.,M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ID",
            "license": "D-3549-OR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca J Smith, PHARM.D.
• Rheanon Rene' Smith, LCPC
• Robert F Smith, MD
• Rusty Smith, PSYD
• Samantha Jo Smith, PA-C
• Sara Jean Smith, NP-BC
• Scott Smith, MD
• Selena P Smith, PSY.D.
• Stephanie Ann Smith, MSW, LCSW
• Stephen C Smith, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Boise, ID
• Providers in Boise, ID by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.