Christopher D Smith, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D5788 Issued in AZ

Practice address

1658 Oaklawn Drive
Suite B
Prescott, AZ 86305

Phone

(928) 771-1640

Fax

(928) 771-1673

NPI assigned

Mar 28, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

State licenses

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.

• Prescott Endodontic Associates PC

  • Endodontics
  • Prescott, AZ
  • NPI 1588620231
  NPD (past) Authorized official

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104945682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1658 OAKLAWN DRIVE",
            "address_2": "SUITE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86305",
            "telephone_number": "928-771-1640",
            "fax_number": "928-771-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1658 OAKLAWN DRIVE",
            "address_2": "SUITE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86305",
            "telephone_number": "928-771-1640",
            "fax_number": "928-771-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHRISTOPHER",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "D5788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA INS",
            "identifier": "1516207",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Sitrin, MSN,RN, ACNP-BC
• Doreen Ann Slabaugh, D.O.
• Sleep Synergies, LLC
• Smi Imaging LLC
• Adam Christopher Smith, PHARMD
• James Malcolm Smith, R.PH.
• Janine Smith
• Jimmy D Smith Jr., FNP
• Kelly Sue Smith, M.A., CCC-SLP
• Madison Smith, PA-C

• Endodontics in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Endodontics in Arizona

• 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.