Dr. Jack O. Smalley DSS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DR. JACK O. SMALLEY DSS

Practice address

2650 E Pinon Frontage Rd BLDG 300
Farmington, NM 87402-5084

Phone

(505) 327-3331

Fax

(505) 327-0873

NPI assigned

Nov 1, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Deanza D Sona, RDA

Title

Office Manager

Phone

(505) 327-3331

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jared Reese Foutz, DMD

  • Dentist
  • Farmington, NM
  • NPI 1558244970
  NPD (past)
• Dawn K Glover, DDS

  • Dentist
  • Los Alamos, NM
  • NPI 1699041905
  NPD (past)
• Jack Owen Smalley, D.D.S.

  • General Practice Dentistry
  • Farmington, NM
  • NPI 1487611331
  NPD (past)

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541030400000",
    "number": "1063989531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 E PINON FRONTAGE RD BLDG 300",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874025084",
            "telephone_number": "505-327-3331",
            "fax_number": "505-327-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 E PINON FRONTAGE RD BLDG 300",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874025084",
            "telephone_number": "505-327-3331",
            "fax_number": "505-327-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JACK O. SMALLEY DSS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-01",
        "last_updated": "2018-11-01",
        "status": "A",
        "authorized_official_last_name": "SONA",
        "authorized_official_first_name": "DEANZA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "505-327-3331",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RDA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84279826",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason S Doolin, D.C.
• Tori Cherie Doolin, LMT
• Denise M Dorner, DPM
• Dr David Herman's Four Corners Dental, LLC
• Dr David J Herman's Four Corners Dental, LLC
• Dr. Jack Smalley D.D.S.
• Dr. Joseph a. Wilson DMD, MSD, LLC
• Dr. Marina Hampton DDS
• Karlee A Drake
• Duane E Vanderslice, M.D., F.a.C.O.G., P.C. (Women's Clinic)

• General Practice Dentistry in Farmington, NM
• Providers in Farmington, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.