Gregg W. Smith, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12007736A Issued in IN

Practice address

2186 N Hospital Blvd Ste 1
Sullivan, IN 47882-7654

Phone

(812) 268-4010

Fax

(812) 268-5607

NPI assigned

Jan 6, 2006

Last updated

Feb 22, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sullivan Family Dentistry, LLC

  • General Practice Dentistry
  • Sullivan, IN
  • NPI 1871996199
  Authorized official Same address or phone

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1073591277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2186 N HOSPITAL BLVD STE 1",
            "address_2": "PO BOX 468",
            "city": "SULLIVAN",
            "state": "IN",
            "postal_code": "478827654",
            "telephone_number": "812-268-4010",
            "fax_number": "812-268-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2186 N HOSPITAL BLVD STE 1",
            "city": "SULLIVAN",
            "state": "IN",
            "postal_code": "478827654",
            "telephone_number": "812-268-4010",
            "fax_number": "812-268-5607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GREGG",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007736A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100225990",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rural Community Schools, Inc. (Rural Community Academy)
• Angela Beth Sagarsee, R.D., C.D.
• Carson Sandy, DC
• Tabitha Dee Simpson
• Darin Sisil
• Neil Lynn Smith, D.D.S
• Stacey L Smith, FNP
• Sydney Danielle Smith
• Solidago Dialysis, LLC (Sullivan Dialysis)
• Southwest School Corporation

• General Practice Dentistry in Sullivan, IN
• Providers in Sullivan, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.