Dr. Jack Smalley D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

1918 Issued in NM

Legal business name

DR. JACK SMALLEY D.D.S.

Practice address

1700 N Butler Ave
Farmington, NM 87401-6331

Phone

(505) 327-3331

Fax

(505) 327-0873

NPI assigned

Jan 27, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Deanza Dawn Sona

Title

Office Manager

Phone

(505) 327-3331

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264550400000",
    "number": "1073844221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N BUTLER AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016331",
            "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": "1700 N BUTLER AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016331",
            "telephone_number": "505-327-3331",
            "fax_number": "505-327-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JACK SMALLEY D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-27",
        "last_updated": "2010-01-27",
        "status": "A",
        "authorized_official_last_name": "SONA",
        "authorized_official_first_name": "DEANZA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "505-327-3331",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NM",
            "license": "1918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lou Anne Dunaway, O.T.

• Dentist in Farmington, NM
• Providers in Farmington, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; 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.