Jeffrey Smith, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7717 Issued in IA

Practice address

220 W Ridgeway
Suite 201
Waterloo, IA 50701

Phone

(319) 232-9023

Fax

(319) 232-1610

NPI assigned

Aug 22, 2006

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Edwards & Smith Family Dentistry

  • General Practice Dentistry
  • Waterloo, IA
  • NPI 1689785768
  NPD (past) Authorized official

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114033248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 RUSSELL RD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "50701",
            "telephone_number": "319-233-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W RIDGEWAY",
            "address_2": "SUITE 201",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "50701",
            "telephone_number": "319-232-9023",
            "fax_number": "319-232-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCCI",
            "identifier": "506900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "25629",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0163089",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Slifka, ARNP
• Smith Counseling Services, LLC
• Aryana Patricia Smith
• Ethan J Smith, DDS
• Gregory James Smith, AU.D.
• Jeffrey Scott Smith
• Kelli Jean Smith, LISW
• Madeline Smith
• Matthew J Smith, MD
• Meredith Colleen Smith, TLMHC

• General Practice Dentistry in Waterloo, IA
• Providers in Waterloo, IA by specialty
• General Practice Dentistry in Iowa

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.