Constance Elizabeth Smith, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2901012155 Issued in MI

Practice address

1931 Horton Rd
Suite #14
Jackson, MI 49203-5594

Phone

(517) 787-7520

Fax

(517) 787-2575

NPI assigned

Jul 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jackson Dental Innovations PLLC

  • Dental Clinic/Center
  • Jackson, MI
  • NPI 1548027063
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104858778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 HORTON RD",
            "address_2": "SUITE #14",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492035594",
            "telephone_number": "517-787-7520",
            "fax_number": "517-787-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 HORTON RD",
            "address_2": "SUITE #14",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492035594",
            "telephone_number": "517-787-7520",
            "fax_number": "517-787-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CONSTANCE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901012155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smiles on Wheels
• Abigail Susan Smith, MD
• Brent Roderick Smith, PSY.D.
• Channing Marshall Smith, M.D.
• Charity Smith
• Destiny Lynn Madison Smith
• Elizabeth Lee-Smith Smith, MSW
• Gloria J Smith, DDS
• Jaelin Smith
• Jessica Lynn Smith, LMSW

• Dentist in Jackson, MI
• Providers in Jackson, MI by specialty
• Dentist in Michigan

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.