Keenan W. Smith, D.M.D., P.a.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

4348 Issued in SC

Legal business name

KEENAN W. SMITH, D.M.D., P.A.

Practice address

40 Creekview CT
Greenville, SC 29615-4800

Phone

(864) 676-0825

Fax

(864) 676-9859

NPI assigned

Apr 30, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Keenan Webster Smith, D.M.D.

Title

President

Phone

(864) 676-0825

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241049600000",
    "number": "1073757381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CREEKVIEW CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154800",
            "telephone_number": "864-676-0825",
            "fax_number": "864-676-9859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CREEKVIEW CT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154800",
            "telephone_number": "864-676-0825",
            "fax_number": "864-676-9859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEENAN W. SMITH, D.M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-30",
        "last_updated": "2009-04-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KEENAN",
        "authorized_official_middle_name": "WEBSTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-676-0825",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "SC",
            "license": "4348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX4348",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jocelyn R Keefer, OT
• Mary Keel, MFTA
• Keeley Psychiatry of South Carolina, LLC
• Kylie Madison Eblen Keelty, MD
• April Keen, RD
• Tina Oliviae Keene, AU.D.
• Katherine Parker Keener
• Martina Looser Keener, RPH
• Sara Keeney, MCD, CCC-SLP
• Alicia Boudreaux Keenhold, RN

• Dental Clinic/Center in Greenville, SC
• Providers in Greenville, SC by specialty
• Dental Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; 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.