Justin R Smith DMD PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JUSTIN R SMITH DMD PA

Doing business as

St. Andrews Dental Center

Practice address

2407 Saint Andrews Blvd
Panama City, FL 32405-2170

Phone

(850) 763-5021

NPI assigned

Sep 13, 2022

Last updated

Sep 13, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jenny Garcia

Title

Credentialing Lead

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• St. Andrews Dental Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Justin R Smith, D.M.D.

  • Dentist
  • Panama City, FL
  • NPI 1497061634

  General Practice

  NPD (past)

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1215659776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2407 SAINT ANDREWS BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324052170",
            "telephone_number": "850-763-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2407 SAINT ANDREWS BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324052170",
            "telephone_number": "850-763-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN R SMITH DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "CREDENTIALING LEAD",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Andrews Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Janet Justice, LCSW
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• Gwen R Kady, PT
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• General Practice Dentistry in Panama City, FL
• Providers in Panama City, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.