Individual provider Active NPI

M Kent Smith, DDS

  • Pharmacist
  • Indianapolis, IN
National Provider Identifier
1104934934
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26014842A Issued in IN
Practice address
3838 N Rural St
Indianapolis, IN 46205-2930
Phone
(317) 221-2306
Fax
(317) 221-2336
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12008731A IN
Pharmacist 183500000X 26014842A IN Primary

Addresses

Primary practice location

3838 N Rural St
Indianapolis, IN 46205-2930

Mailing address

3391 N 700 W
Arlington, IN 46104-9431
Phone (765) 663-2829

Other names 1

  • Matthew Kent Smith Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20160929001335 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5193012417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12008731AINMDGeneral Practice Dentistry
26014842AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1104934934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3391 N 700 W",
            "city": "ARLINGTON",
            "state": "IN",
            "postal_code": "461049431",
            "telephone_number": "765-663-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 N RURAL ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462052930",
            "telephone_number": "317-221-2306",
            "fax_number": "317-221-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "M KENT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008731A",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26014842A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATTHEW",
            "last_name": "SMITH",
            "middle_name": "KENT",
            "credential": "R.PH.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.