Individual provider Active NPI

Joe T Smith, D.D.S

  • Dentist
  • Tyler, TX
National Provider Identifier
1174803951
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
23885 Issued in TX
Practice address
5400 New Copeland Rd
Tyler, TX 75703-3950
Phone
(903) 534-1171
Fax
(903) 534-6054
NPI assigned
Aug 24, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 23885 TX Primary

Addresses

Primary practice location

5400 New Copeland Rd
Tyler, TX 75703-3950

Mailing address

5400 New Copeland Rd
Tyler, TX 75703-3950
Phone (903) 534-1171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20160314001713 TX Order and Referring Only - DentistPractitioner - Dentist 8022314251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23885TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Smith, Ogletree, Smith General Partnership Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1174803951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 NEW COPELAND RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033950",
            "telephone_number": "903-534-1171",
            "fax_number": "903-534-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 NEW COPELAND RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033950",
            "telephone_number": "903-534-1171",
            "fax_number": "903-534-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "23885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.