Woody Lyle Smithey Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

LA 4115 Issued in LA

Practice address

900 S Vienna St
Ruston, LA 71270-5830

Phone

(318) 251-0334

Fax

(318) 255-3538

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

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.

• Mercy Medical Health Center

  • Federally Qualified Health Center (FQHC)
  • Ruston, LA
  • NPI 1346907086
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114013182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S VIENNA ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705830",
            "telephone_number": "318-251-0334",
            "fax_number": "318-255-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S VIENNA ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705830",
            "telephone_number": "318-251-0334",
            "fax_number": "318-255-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITHEY",
        "first_name": "WOODY",
        "middle_name": "LYLE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "LA 4115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841153",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "842233",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas P Smith, M.D.
• Trey Smith, PT
• William C Smith, M.D.
• Willie Smith
• Zaykeeah Smith
• Sharon Hewitt Sneed
• Jimmy A Snow Jr., LPC
• Marcella Joy Snow, BSN, RN, IBCLC, RLC
• Sarah Snowden
• Garrett Price Soileau, PA-C

• All providers in Ruston, LA
• General Practice Dentistry in Louisiana

• 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.