Individual provider Active NPI

David Michael Smith, DDS

  • Dentist
  • Minot AFB, ND
National Provider Identifier
1235112491
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3366 Issued in TN
Practice address
10 Missle Ave
Minot AFB, ND 58705-5003
Phone
(701) 723-5557
Fax
(701) 723-5555
NPI assigned
Nov 22, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3366 TN Primary

Addresses

Primary practice location

10 Missle Ave
Minot AFB, ND 58705-5003

Mailing address

121 Coral CT
Minot AFB, ND 58704-1319
Phone (701) 727-5424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20140714000839 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5496970147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3366TNMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1235112491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CORAL CT",
            "city": "MINOT AFB",
            "state": "ND",
            "postal_code": "587041319",
            "telephone_number": "701-727-5424",
            "fax_number": "701-723-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MISSLE AVE",
            "city": "MINOT AFB",
            "state": "ND",
            "postal_code": "587055003",
            "telephone_number": "701-723-5557",
            "fax_number": "701-723-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "3366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot AFB, ND

Sources for this page

Verify at the official NPI Registry.