Michael James Smith, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

035261 Issued in NY

Practice address

91 Lakes Rd
Monroe, NY 10950-2613

Phone

(845) 782-4220

Fax

(845) 783-4846

NPI assigned

Feb 27, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2018 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1023084274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL ARTS BUILDING",
            "address_2": "91 LAKES ROAD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "10950",
            "telephone_number": "845-782-4220",
            "fax_number": "845-783-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 LAKES RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109502613",
            "telephone_number": "845-782-4220",
            "fax_number": "845-783-4846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "035261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00727284",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Skoglund
• Alicia Skowronski
• Small Footsteps Licensed Behavior Analysis PC
• Deanna M Smith, P.T.
• Kara Smith, RN
• Patricia Ruth Smith, LMSW
• Tara Smith, RDH
• Catherine M Sobel, CATHERINE SOBEL
• Avraham Sokoloff, R.P.A.
• Jay E Solomon

• Oral and Maxillofacial Surgery (Dentist) in Monroe, NY
• Providers in Monroe, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.