Individual provider Active NPI

Melissa Averett Smith, RDH, RN

  • Dental Hygienist
  • Unadilla, GA
National Provider Identifier
1083789473
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH005671 Issued in GA
Practice address
2858 Pine Street
Unadilla, GA 31091
Phone
(478) 627-3263
NPI assigned
Nov 21, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH005671 GA Primary
Community Health Registered Nurse 163WC1500X RN133584 GA

Addresses

Primary practice location

2858 Pine Street
Unadilla, GA 31091

Mailing address

390 Wildwood Rd
Fort Valley, GA 31030-2813
Phone (478) 627-3263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
DH005671GAMDDental Hygienist
RN133584GAMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1083789473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 WILDWOOD RD",
            "city": "FORT VALLEY",
            "state": "GA",
            "postal_code": "310302813",
            "telephone_number": "478-627-3263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2858 PINE STREET",
            "city": "UNADILLA",
            "state": "GA",
            "postal_code": "31091",
            "telephone_number": "478-627-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MELISSA",
        "middle_name": "AVERETT",
        "credential": "RDH, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "GA",
            "license": "DH005671",
            "primary": true
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "GA",
            "license": "RN133584",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Unadilla, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.