Active NPI
Ciaran Smythe
- Dermatology Physician
- Dallas, TX
National Provider Identifier
1093274318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- W7133
- Practice address
- 11615 Forest Central Dr Ste 107
Dallas, TX 75243-3921 - Phone
- (503) 758-2390
- NPI assigned
- Mar 16, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | W7133 | TX | Primary |
Addresses
Primary practice location
11615 Forest Central Dr Ste 107
Dallas, TX 75243-3921
Mailing address
11615 Forest Central Dr Ste 107
Dallas, TX 75243-3921
Phone (503) 758-2390
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788739200000",
"number": "1093274318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11615 FOREST CENTRAL DR STE 107",
"city": "DALLAS",
"state": "TX",
"postal_code": "752433921",
"telephone_number": "503-758-2390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11615 FOREST CENTRAL DR STE 107",
"city": "DALLAS",
"state": "TX",
"postal_code": "752433921",
"telephone_number": "503-758-2390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMYTHE",
"first_name": "CIARAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-16",
"last_updated": "2026-09-07",
"certification_date": "2026-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "TX",
"license": "W7133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.