Active NPI
Paul Stephen Smith, DDS
- Dentist
- Raf Croughton, TX
National Provider Identifier
1225628167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 35141
- Practice address
- BLDG 140
Raf Croughton, TX 09494 - Phone
- (314) 236-8739
- NPI assigned
- Jan 25, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 35141 | TX | |
| Dentist | 122300000X | 35141 | TX | Primary |
Addresses
Primary practice location
BLDG 140
Raf Croughton, TX 09494
Mailing address
300 Tuskegee Blvd
Dover Air Force Base, DE 19902-5003
Phone (302) 677-2028
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 |
|---|---|---|---|
| 35141 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689897600000",
"number": "1225628167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 TUSKEGEE BLVD",
"city": "DOVER AIR FORCE BASE",
"state": "DE",
"postal_code": "199025003",
"telephone_number": "302-677-2028",
"fax_number": "302-677-3231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BLDG 140",
"city": "RAF CROUGHTON",
"state": "TX",
"postal_code": "09494",
"telephone_number": "314-236-8739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "PAUL",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-25",
"last_updated": "2023-07-21",
"certification_date": "2023-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "35141",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "35141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.