Individual provider Active NPI

Kandis Alexis Smith, DMD, MA

  • General Practice Dentistry
  • North Easton, MA
National Provider Identifier
1215290754
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1856022 Issued in MA
Practice address
690 Depot St
North Easton, MA 02356-2700
Phone
(508) 238-2924
NPI assigned
Jun 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1856022 MA
General Practice Dentistry 1223G0001X DN1856022 MA Primary

Addresses

Primary practice location

690 Depot St
North Easton, MA 02356-2700

Mailing address

1 Newport Ave Apt 612
Quincy, MA 02171-2661
Phone (857) 294-6168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160419000439 MA Order and Referring Only - DentistPractitioner - Dentist 9638477003

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Boston Univ Goldman School of Dental Medicine, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1325 Bridge Mill Ave
Canton, GA 30114-7762

690 Depot St
Suite 3
North Easton, MA 02356-2764

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Integrity Solutions PC General Practice CurrentSince Apr 15, 2022 Accepting new patients
Roxbury Comprehensive Community Health Center, Inc. PastSince Aug 21, 1997 Accepting new patients
Roxbury Comprehensive Community Health Center Past Accepting new patients
Smilevana PastSince May 6, 2026 Accepting new patients

Locations

690 Depot St
Ste 3
North Easton, MA 02356
Phone (508) 238-2924

Organizations & group practices 4

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1215290754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NEWPORT AVE APT 612",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021712661",
            "telephone_number": "857-294-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 DEPOT ST",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023562700",
            "telephone_number": "508-238-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KANDIS",
        "middle_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "DMD, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856022",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1856022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Easton, MA

Sources for this page

Verify at the official NPI Registry.