Active NPI
Gary Webster Smith, DMD
- Dentist
- Calvert City, KY
National Provider Identifier
1104127125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4470
- Practice address
- 404 Fifth Ave.
Calvert City, KY 42029 - Phone
- (270) 395-7116
- Fax
- (270) 395-7439
- NPI assigned
- Nov 8, 2010
- Last updated
- Nov 8, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 4470 | KY | Primary |
Addresses
Primary practice location
404 Fifth Ave.
Calvert City, KY 42029
Mailing address
PO Box 304
Calvert City, KY 42029
Phone (270) 395-7116
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 |
|---|---|---|---|
| 4470 | KY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289174400000",
"number": "1104127125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 304",
"city": "CALVERT CITY",
"state": "KY",
"postal_code": "42029",
"telephone_number": "270-395-7116",
"fax_number": "270-395-7439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 FIFTH AVE.",
"city": "CALVERT CITY",
"state": "KY",
"postal_code": "42029",
"telephone_number": "270-395-7116",
"fax_number": "270-395-7439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "GARY",
"middle_name": "WEBSTER",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-08",
"last_updated": "2010-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "4470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Calvert City, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.