Individual provider Active NPI

Kiley Aaron Smith, D.D.S.

  • Dentist
  • Whitney, TX
National Provider Identifier
1104051259
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
24558 Issued in TX
Practice address
1502 North Brazos
Whitney, TX 76692
Phone
(254) 694-3111
NPI assigned
May 19, 2009
Last updated
May 19, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 24558 TX Primary

Addresses

Primary practice location

1502 North Brazos
Whitney, TX 76692

Mailing address

PO Box 1197
Whitney, TX 76692-1197
Phone (254) 541-8421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150428000810 TX Order and Referring Only - DentistPractitioner - Dentist 0446579395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24558TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rick E Cofer DDS PA Dentist Past Accepting new patients
Jay H. Oakey D.D.S., P.C. Dentist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242691200000",
    "number": "1104051259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1197",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766921197",
            "telephone_number": "254-541-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 NORTH BRAZOS",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "76692",
            "telephone_number": "254-694-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KILEY",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "24558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitney, TX

Sources for this page

Verify at the official NPI Registry.