Active NPI
Tessa M Smith, DDS
- Pediatric Dentistry
- Slidell, LA
National Provider Identifier
1093881732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 5141
- Practice address
- 2960 E Gause Blvd
Slidell, LA 70461 - Phone
- (985) 641-3988
- Fax
- (985) 646-2536
- NPI assigned
- Nov 27, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 5141 | LA | Primary |
Addresses
Primary practice location
2960 E Gause Blvd
Slidell, LA 70461
Mailing address
2960 E Gause Blvd
Slidell, LA 70461
Phone (985) 641-3988
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851418 | Medicaid | LA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5141 | LA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093881732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2960 E GAUSE BLVD",
"city": "SLIDELL",
"state": "LA",
"postal_code": "70461",
"telephone_number": "985-641-3988",
"fax_number": "985-646-2536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2960 E GAUSE BLVD",
"city": "SLIDELL",
"state": "LA",
"postal_code": "70461",
"telephone_number": "985-641-3988",
"fax_number": "985-646-2536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "TESSA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "LA",
"license": "5141",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1851418",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Slidell, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.