Scott Raymond Smith, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12556 Issued in MI

Practice address

770 Riverside Ave
Ste 201
Adrian, MI 49221-1465

Phone

(517) 265-5577

Fax

(517) 265-8068

NPI assigned

May 24, 2005

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

Enrolled in MI

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

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.

• Scott R. Smith DDS.,PC

  • General Practice Dentistry
  • Adrian, MI
  • NPI 1609011311
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1154324002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 RIVERSIDE AVE",
            "address_2": "STE 201",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211465",
            "telephone_number": "517-265-5577",
            "fax_number": "517-265-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 RIVERSIDE AVE",
            "address_2": "STE 201",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211465",
            "telephone_number": "517-265-5577",
            "fax_number": "517-265-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SCOTT",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2026-07-13",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "12556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Lee Smith
• Jessica Smith
• Kayla B Smith, PT, DPT
• Kelsey Leeann Smith
• Samantha Emily Smith
• Wayne A Smith, MD
• Willie Darrell Smith, O.D.
• Melody Smolik
• Steven M Smolinski, M.D., PH.D.
• Rick Allen Snow, OD

• General Practice Dentistry in Adrian, MI
• Providers in Adrian, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.