Active NPI
Vincent Robert Smith, DDS
- General Practice Dentistry
- Carolina Beach, NC
National Provider Identifier
1184635302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4592
- Practice address
- 1300 Bridge Barrier Rd
Carolina Beach, NC 28428 - Phone
- (910) 458-9401
- Fax
- (910) 458-3495
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4592 | NC | Primary |
Addresses
Primary practice location
1300 Bridge Barrier Rd
Carolina Beach, NC 28428
Mailing address
1300 Bridge Barrier Rd
Carolina Beach, NC 28428
Phone (910) 458-9401
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 97952 | Other | NC | BLUE CROSS BLUE SHIELD |
| 8997952 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4592 | NC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brandon Kent Farrell DDS PA II | General Practice | 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.
-
- General Practice Dentistry
- Carolina Beach, NC
- NPI 1801124789
General Practice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184635302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 BRIDGE BARRIER RD",
"city": "CAROLINA BEACH",
"state": "NC",
"postal_code": "28428",
"telephone_number": "910-458-9401",
"fax_number": "910-458-3495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 BRIDGE BARRIER RD",
"city": "CAROLINA BEACH",
"state": "NC",
"postal_code": "28428",
"telephone_number": "910-458-9401",
"fax_number": "910-458-3495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "VINCENT",
"middle_name": "ROBERT",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "4592",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "97952",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8997952",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carolina Beach, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.