Don Edwin Smith Jr., D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2961-96 Issued in MS

Practice address

300 W Adams St
Kosciusko, MS 39090-3644

Phone

(662) 289-2570

Fax

(662) 289-2580

NPI assigned

Jan 16, 2007

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

Enrolled in MS

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

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073665691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W ADAMS ST",
            "address_2": "P.O. BOX 627",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903644",
            "telephone_number": "662-289-2570",
            "fax_number": "662-289-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W ADAMS ST",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903644",
            "telephone_number": "662-289-2570",
            "fax_number": "662-289-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DON",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "2961-96",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660161",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiara N Sanders, NP
• Rebecca Shields, PTA
• Makenzie Simmons, DPT
• Christi W Sims, P.T.
• Don E. Smith Sr., DDS
• Timothy M. South, FNP
• Southern Pharmaceutical Corporation
• Tanya L Steen, O.T.
• Sullivan'S Discount Drugs Inc.
• Sullivan'S Discount Drugs, Inc

• General Practice Dentistry in Kosciusko, MS
• Providers in Kosciusko, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.