Jacob Oliver Smith, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4412 Issued in AR

Practice address

4307 S Pleasant Crossing Blvd Ste 103
Rogers, AR 72758-1347

Phone

(479) 553-9215

NPI assigned

Apr 22, 2013

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Exo Dental PLLC

  • General Practice Dentistry
  • Rogers, AR
  • NPI 1730851296
  NPD Authorized official
• Exo Dental Van Buren PLLC

  • Dental Clinic/Center
  • Van Buren, AR
  • NPI 1801738836
  NPD Authorized official
• Exo Dental Topeka LLC

  • Dental Clinic/Center
  • Topeka, KS
  • NPI 1366252306
  NPD Authorized official

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1063856912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 SE HENDRIX ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124166",
            "telephone_number": "573-380-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4307 S PLEASANT CROSSING BLVD STE 103",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581347",
            "telephone_number": "479-553-9215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACOB",
        "middle_name": "OLIVER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-22",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2012019405",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "4412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danessa Lorraine Smith
• Dorothy Leann Smith
• Haley Smith, OTD, OTR/L
• Haley Smith
• Haylie R Smith
• James W Smith, DO
• Jeremy Smith, DDS
• Kathryn H. Smith, CRNA
• Kelly Anne Smith, LCSW
• Lisa Marie Smith, PHARMD

• General Practice Dentistry in Rogers, AR
• Providers in Rogers, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.