Kyle David Smith, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6771 Issued in WI

Practice address

840 N 87TH St
Milwaukee, WI 53226-3586

Phone

(414) 805-5760

Fax

(414) 259-9115

NPI assigned

Mar 27, 2011

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

Opted out of Medicare

Yes, effective Sep 30, 2020 through Sep 30, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1301184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1144529322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 N 87TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263586",
            "telephone_number": "414-805-5760",
            "fax_number": "414-259-9115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N 87TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263586",
            "telephone_number": "414-805-5760",
            "fax_number": "414-259-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KYLE",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-27",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "6771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karly Smith, LPN
• Kelly F Smith, DO
• Kinaya Smith, MD
• Kristin D Smith, PHD
• Kristin Lyn Smith, PHARM D
• La Monte Smith, MSW
• Latoya M Smith
• Laura D Smith
• Lawon A Smith, DONA CD
• Leonard B Smith

• Oral and Maxillofacial Surgery (Dentist) in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.