Nancy Lynn Smith, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

1356 Shermer Rd
Northbrook, IL 60062-4581

Phone

(847) 272-0073

Fax

(847) 272-2138

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

Yes

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

Enrolled in WI

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

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1164595195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1356 SHERMER RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624581",
            "telephone_number": "847-272-0073",
            "fax_number": "847-272-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1356 SHERMER RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624581",
            "telephone_number": "847-272-0073",
            "fax_number": "847-272-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NANCY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102702",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004878",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102630",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alysa Slay, PSY.D.
• Abbigail Smith
• Deandra Smith
• Jennifer Marie Smith, LCPC
• Lorena Smith
• Nicole Louise Smith, LCSW
• Sarah Lynn Smith, FNP
• Anne M Smoczynski
• Marlena Smosna
• Kimberly Rose Smythe

• General Practice Dentistry in Northbrook, IL
• Providers in Northbrook, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.