Active NPI
Chad Smylie, DMD
- Dentist
- Los Angeles, CA
National Provider Identifier
1043900012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 113681
- Practice address
- 522 S San Pedro St
Los Angeles, CA 90013-2102 - Phone
- (562) 867-7999
- NPI assigned
- May 11, 2023
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 113681 | CA | Primary |
Addresses
Primary practice location
522 S San Pedro St
Los Angeles, CA 90013-2102
Mailing address
522 S San Pedro St
Los Angeles, CA 90013-2102
Medicare participation
Medicare enrollment files- 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: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787702400000",
"number": "1043900012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 S SAN PEDRO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900132102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "522 S SAN PEDRO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900132102",
"telephone_number": "562-867-7999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMYLIE",
"first_name": "CHAD",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-11",
"last_updated": "2026-08-26",
"certification_date": "2026-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "113681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.