Justin Richard Smith, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE 10914 Issued in WA

Practice address

3710 168TH St NE
Suite B-105
Arlington, WA 98223-8461

Phone

(360) 657-1650

Fax

(360) 657-1502

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1235346594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 ALDER ST",
            "city": "CAMANO ISLAND",
            "state": "WA",
            "postal_code": "982828672",
            "telephone_number": "360-657-1650",
            "fax_number": "360-657-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 168TH ST NE",
            "address_2": "SUITE B-105",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982238461",
            "telephone_number": "360-657-1650",
            "fax_number": "360-657-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JUSTIN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "19026756",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE 10914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5054846",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittney Sito, RDN
• Skagit Valley Medical Center Dba Cascade Family Medical Group
• Todd C. Skiles, D.P.M.
• Sleep Diagnostics NW PLLC
• Edmund Harry Smith, SUDP
• Smokey Point Family Dentistry, PLLC
• Smokey Point Massage
• Wayne Smothers, DVM
• Jacqueline Snapp, DDS
• Snohomish County Fire Protection District #22

• Pediatric Dentistry in Arlington, WA
• Providers in Arlington, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.