Individual provider Active NPI

Christopher Chad Smith, DDS

  • Dentist
  • Manchester, TN
National Provider Identifier
1043437072
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8107 Issued in TN
Practice address
1240 McArthur St
Manchester, TN 37355-2445
Phone
(931) 728-3501
Fax
(931) 728-3554
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS8107 TN
Dentist 122300000X 8107 TN Primary

Addresses

Primary practice location

1240 McArthur St
Manchester, TN 37355-2445

Mailing address

1240 McArthur St
Manchester, TN 37355-2445
Phone (931) 728-3501

Other identifiers 2

IdentifierTypeStateIssuer
5440263MedicaidTN
4122760OtherBLUE CROSS BLUE SHEILD TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151221002449 TN Practitioner - Oral Surgery 8426359225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS8107TNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul E. Honeycutt, DDS PastSince Sep 29, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1043437072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 MCARTHUR ST",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373552445",
            "telephone_number": "931-728-3501",
            "fax_number": "931-728-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 MCARTHUR ST",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373552445",
            "telephone_number": "931-728-3501",
            "fax_number": "931-728-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHRISTOPHER",
        "middle_name": "CHAD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS8107",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "8107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5440263",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD TN",
            "identifier": "4122760",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, TN

Sources for this page

Verify at the official NPI Registry.