Individual provider Active NPI

Edwin Pierre Smith, D.D.S

  • General Practice Dentistry
  • North Miami Beach, FL
National Provider Identifier
1104263813
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN20102 Issued in FL
Practice address
16125 NE 18TH Ave
North Miami Beach, FL 33162-4749
Phone
(305) 949-2766
Fax
(305) 949-4118
NPI assigned
Jun 4, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN20102 FL Primary

Addresses

Primary practice location

16125 NE 18TH Ave
North Miami Beach, FL 33162-4749

Mailing address

16125 NE 18TH Ave
North Miami Beach, FL 33162-4749
Phone (305) 949-2766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160225002046 FL Order and Referring Only - DentistPractitioner - Dentist 1951606136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN20102FLMDGeneral Practice Dentistry
DN20122FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1104263813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16125 NE 18TH AVE",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624749",
            "telephone_number": "305-949-2766",
            "fax_number": "305-949-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16125 NE 18TH AVE",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624749",
            "telephone_number": "305-949-2766",
            "fax_number": "305-949-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EDWIN",
        "middle_name": "PIERRE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-04",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN20102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.