Marc Ryan Smith, D.D.S.

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

19812 Issued in TX

Practice address

15901 Central Commerce Dr
Suite 601
Pflugerville, TX 78660-2041

Phone

(512) 989-7855

Fax

(512) 989-7859

NPI assigned

Sep 28, 2006

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

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

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Capital Oral and Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Pflugerville, TX
  • NPI 1831324540
  NPD (past) Authorized official

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194816520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15901 CENTRAL COMMERCE DR",
            "address_2": "SUITE 601",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786602041",
            "telephone_number": "512-989-7855",
            "fax_number": "512-989-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15901 CENTRAL COMMERCE DR",
            "address_2": "SUITE 601",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786602041",
            "telephone_number": "512-989-7855",
            "fax_number": "512-989-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARC",
        "middle_name": "RYAN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "TX",
            "license": "19812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maritza Nora Solis, PTA, LMT

• Oral and Maxillofacial Pathology Dentistry in Pflugerville, TX
• Providers in Pflugerville, TX by specialty
• Oral and Maxillofacial Pathology Dentistry in Texas

• 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.
• 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.