Justen Brent Smith, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4183 Issued in OK

Practice address

5031 E 116TH St N
Sperry, OK 74073-4199

Phone

(918) 288-7695

Fax

(918) 288-7695

NPI assigned

Sep 20, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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.

• 918 Dentist of Sperry, PLLC

  • Public Health Dentistry
  • Sperry, OK
  • NPI 1831081157
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124126263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5031 E 116TH ST N",
            "city": "SPERRY",
            "state": "OK",
            "postal_code": "740734199",
            "telephone_number": "918-288-7695",
            "fax_number": "918-288-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5031 E 116TH ST N",
            "city": "SPERRY",
            "state": "OK",
            "postal_code": "740734199",
            "telephone_number": "918-288-7695",
            "fax_number": "918-288-7695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JUSTEN",
        "middle_name": "BRENT",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "4183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Martin
• Victoria D McDaniel-Tracy, LCSW
• Hazel Arlene Mosier
• Michelle Marie Norris, OT
• Miranda Nicole Scholz, DDS
• Solid Rock Life Therapy Services, LLC
• Chris A Taylor, BHRS

• Dentist in Sperry, OK
• Providers in Sperry, OK by specialty
• Dentist in Oklahoma

• 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.