John Robert Smith, DDS, PA

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

7004 Issued in FL

Practice address

1350 Tuskawilla Rd
Winter Springs, FL 32708-5031

Phone

(407) 699-1102

Fax

(407) 699-4327

NPI assigned

Mar 22, 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

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245356104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 TUSKAWILLA RD",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085031",
            "telephone_number": "407-699-1102",
            "fax_number": "407-699-4327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 TUSKAWILLA RD",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085031",
            "telephone_number": "407-699-1102",
            "fax_number": "407-699-4327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS, PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "7004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia A Shepardson, MA, LMHC
• Jennifer Sims, MSW
• Nikki G Sims
• Krista B Siopes
• Harold Andrew Sloas Jr., D.O.
• Patricia Louise Smith, RN, ATP
• Sovereign Healthcare of Tuskawilla, LLC
• Jecoa G Sowilo, PTA
• Christi Spencer, MA CCC-SLP
• Sarah Vaughn Sprague, MA,CCC,SLP

• Orthodontics and Dentofacial Orthopedics Dentistry in Winter Springs, FL
• Providers in Winter Springs, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.