Stevenson Sander Smith, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9751 Issued in OR

Practice address

911 Country Club Rd Ste 222
Eugene, OR 97401-6046

Phone

(541) 342-2477

NPI assigned

Jul 31, 2012

Last updated

Jul 31, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 22, 2015 through Dec 22, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stevenson Smith DMD LLC

  dba Smith & Jackson Family Dental

  • Dental Clinic/Center
  • Eugene, OR
  • NPI 1174194617
  NPD Authorized official

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1083960793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 COUNTRY CLUB RD STE 222",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016046",
            "telephone_number": "801-885-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 COUNTRY CLUB RD STE 222",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016046",
            "telephone_number": "541-342-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEVENSON",
        "middle_name": "SANDER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-31",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally Smith
• Sharon Maire Smith, PHD
• Shawna Smith
• Sienna Danielle Smith
• Steven Edward Smith, DMD
• Susan Smith
• Thomas Smith, CADC II
• Travis Smith, BS, CADC I
• Tyler Brown Smith, P.T.
• Wesley Smith, DPT

• General Practice Dentistry in Eugene, OR
• Providers in Eugene, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.