NPIMap

Individual provider Active NPI

Daniel James Smith, DMD

  • Dentist
  • Lackland a F B, TX
National Provider Identifier
1033420971
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS038341 Issued in PA
Practice address
2200 Bergquist Dr
Suite 1
Lackland a F B, TX 78236-9907
Phone
(210) 292-7749
Fax
(210) 292-7964
NPI assigned
Jun 25, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS038341 PA Primary

Addresses

Primary practice location

2200 Bergquist Dr
Suite 1
Lackland a F B, TX 78236-9907

Mailing address

2200 Bergquist Dr
Suite 1
Lackland a F B, TX 78236-9907
Phone (210) 292-7749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181008000849 PA Practitioner - Maxillofacial Surgery 3173871480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Temple University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4341 Linglestown Rd
Harrisburg, PA 17112-9531
Phone (717) 545-6200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wood & Myers Oral and Maxillofacial Surgery, P.C. CurrentSince Aug 15, 2018 Accepting new patients
Wood & Myers Oral and Maxillofacial Surgery, PC CurrentSince Aug 15, 2018 Accepting new patients

Locations

207 S 32nd St
Camp Hill, PA 17011
Phone (717) 763-1970

25 Eastgate Dr
Carlisle, PA 17015
Phone (717) 249-7007

4341 Linglestown Rd
Harrisburg, PA 17112
Phone (717) 545-6200

230 Harrisburg Ave
Ste 3
Lancaster, PA 17603
Phone (717) 391-9003

Organizations & group practices 2

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.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1033420971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "SUITE 1",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "210-292-7749",
            "fax_number": "210-292-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "SUITE 1",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369907",
            "telephone_number": "210-292-7749",
            "fax_number": "210-292-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland a F B, TX

Sources for this page

Verify at the official NPI Registry.