Samuel Irby Smith I, DDS, PA

Primary specialty

DentistTaxonomy code 122300000X

License

3056 Issued in NC

Practice address

1001 S Croatan Hwy
Kill Devil Hills, NC 27948-8706

Phone

(252) 449-0700

NPI assigned

Sep 30, 2013

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Samuel Irby Smith DDS PA

  • Dentist
  • Kill Devil Hills, NC
  • NPI 1932390481
  NPD (past) Authorized official

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1164859567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7429",
            "city": "KILL DEVIL HILLS",
            "state": "NC",
            "postal_code": "279487429",
            "telephone_number": "252-449-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S CROATAN HWY",
            "city": "KILL DEVIL HILLS",
            "state": "NC",
            "postal_code": "279488706",
            "telephone_number": "252-449-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SAMUEL",
        "middle_name": "IRBY",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "DDS, PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-30",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "3056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910814",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rikki Rose Schuster, PA
• Sean L. Chapman, D.M.D., P.L.L.C. (First Flight Dental)
• Harvey Hatcher Shiflet V, DMD
• Gary Steven Smith, OPTICIAN
• Nicole Smith
• Spring Arbor Kill Devil Hills NC Tenant, LLC (Spring Arbor Outer Banks)
• Spring Arbor of Nags Head, L.P. (T/A Spring Arbor of the Outer Banks)
• Spring Arbor of Nags Head, L.P.
• Steven M. Doering DMD, PLLC
• Gregory Szymczyk

• Dentist in Kill Devil Hills, NC
• Providers in Kill Devil Hills, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.