John Dale Smith, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-02-0412 Issued in OH

Practice address

3455 Whipple Ave NW
Canton, OH 44718-3034

Phone

(330) 492-7889

Fax

(330) 492-7966

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1225185168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 WHIPPLE AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183034",
            "telephone_number": "330-492-7889",
            "fax_number": "330-492-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 WHIPPLE AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183034",
            "telephone_number": "330-492-7889",
            "fax_number": "330-492-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHN",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-02-0412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Smith, RBT
• Erin N. Smith, M.A.
• Felicia Paulette Smith
• Jay Darren Smith, DC
• Jetaiya Smith, QMHS BA CMS BA
• Judith L. Smith, LSW, PCC
• Katrina Smith, CT
• Kevin Smith, LSW
• Kylie Smith, LPC
• Lane R. Smith, M.D.

• General Practice Dentistry in Canton, OH
• Providers in Canton, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.