John Randall Smoot, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7482 Issued in KY

Practice address

108 Medical Park Dr
Campbellsville, KY 42718-7638

Phone

(270) 465-7781

Fax

(270) 465-7781

NPI assigned

Dec 6, 2006

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

Medicare fee-for-service enrollment

Enrolled in KY

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1073672374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 MEDICAL PARK DR",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427187638",
            "telephone_number": "270-465-7781",
            "fax_number": "270-465-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 MEDICAL PARK DR",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427187638",
            "telephone_number": "270-465-7781",
            "fax_number": "270-465-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOOT",
        "first_name": "JOHN",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Smith, CSW
• Lindsey Renee Smith
• Vonnea Smith
• William Smith, MD
• Smoot Dental Dre PLLC
• Kristina Lynn Smothers, LCSW
• Sound Path, LLC
• Southern Women'S Care Obstetrics & Gynecology, PLLC
• Taylor Southern
• Judy Spagnoletti

• General Practice Dentistry in Campbellsville, KY
• Providers in Campbellsville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.