Greta R Smidt

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

108257 Issued in CA

Practice address

413 5TH Ave NW
Jasper, FL 32052-7801

Phone

(229) 269-5001

NPI assigned

Apr 23, 2019

Last updated

Jan 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1124682497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11936 DARLINGTON AVE APT 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495651",
            "telephone_number": "229-251-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 5TH AVE NW",
            "city": "JASPER",
            "state": "FL",
            "postal_code": "320527801",
            "telephone_number": "229-269-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIDT",
        "first_name": "GRETA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "7282",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN24543",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "108257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quality Phlebotomy LLC
• Anjana Rana, M.D.
• Renaldas Algirdas Smidtas
• Joshua Richardson
• Denise Marie Selph, LMT
• Renaldas Smidtas, MD
• Smith Caring Transport,LLC
• Jerry B. B. Smith Jr., D.M.D
• Timberly Lauren Steichen, PTA
• Suwannee FL Opco LLC (Suwannee Valley Nursing Center)

• Prosthodontics in Jasper, FL
• Providers in Jasper, FL by specialty
• Prosthodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.