Active NPI
John Thomas Smith, D.D.S.
- General Practice Dentistry
- San Anselmo, CA
National Provider Identifier
1033219522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 18016
- Practice address
- 915 Sir Francis Drake Blvd
San Anselmo, CA 94960-1913 - Phone
- (415) 453-1666
- Fax
- (415) 454-7790
- NPI assigned
- Sep 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 18016 | CA | Primary |
Addresses
Primary practice location
915 Sir Francis Drake Blvd
San Anselmo, CA 94960-1913
Mailing address
915 Sir Francis Drake Blvd
San Anselmo, CA 94960-1913
Phone (415) 453-1666
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18016 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033219522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 SIR FRANCIS DRAKE BLVD",
"city": "SAN ANSELMO",
"state": "CA",
"postal_code": "949601913",
"telephone_number": "415-453-1666",
"fax_number": "415-454-7790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 SIR FRANCIS DRAKE BLVD",
"city": "SAN ANSELMO",
"state": "CA",
"postal_code": "949601913",
"telephone_number": "415-453-1666",
"fax_number": "415-454-7790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JOHN",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "18016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Anselmo, CA
Sources for this page
- 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.