Mason Bart Smith

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

14251849-9925 Issued in UT

Practice address

772 N Dixie Dr Ste 101
St George, UT 84770-7444

Phone

(435) 628-0511

NPI assigned

Apr 16, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: msmith658778@direct.ynhh.org

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.

• Johnson Pediatric Dentistry

  • Dental Clinic/Center
  • St George, UT
  • NPI 1578386629
  NPD (past)
• Sunrise Mountain Dental and Orthodontics

  • Dental Clinic/Center
  • Henderson, NV
  • NPI 1295558344
  NPD (past)

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1063266997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "772 N DIXIE DR STE 101",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847707444",
            "telephone_number": "436-628-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "772 N DIXIE DR STE 101",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847707444",
            "telephone_number": "435-628-0511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "256 E Lake Mead Pkwy Ste C",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890155585",
            "country_code": "US",
            "telephone_number": "702-703-5410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MASON",
        "middle_name": "BART",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-16",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NV",
            "license": "S6-250C",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "14251849-9925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lary J Smith, DPM
• Laura Smith
• Madison Marie Smith, MS BCBA
• Makaela Beth Smith
• Marlee Smith
• Melanie Smith, BCBA
• Michael Smith, PHARMD
• Nicole Yvonne Smith
• Pamela Alejandra Smith, DNP, NP
• Paul Wayne Smith

• Pediatric Dentistry in St George, UT
• Providers in St George, UT by specialty
• Pediatric Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.

Verify at the official NPI Registry.