Dustin Michael Smolenski, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

08646 Issued in IA

Practice address

5105 Jersey Ridge Rd
Davenport, IA 52807-3134

Phone

(563) 359-9144

Fax

(563) 359-9146

NPI assigned

Jul 3, 2009

Last updated

Dec 9, 2015By the provider in NPPES

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jersey Ridge Dental Associates

  • General Practice Dentistry
  • Davenport, IA
  • NPI 1194892521
  NPD (past)

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

{
    "created_epoch": "1246579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1245469881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5633 QUERCUS LN",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528061837",
            "telephone_number": "563-359-9144",
            "fax_number": "563-359-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5105 JERSEY RIDGE RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073134",
            "telephone_number": "563-359-9144",
            "fax_number": "563-359-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLENSKI",
        "first_name": "DUSTIN",
        "middle_name": "MICHAEL",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-03",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John M Smith, MSED, NCC, LMHC
• Paul R Smith, DDS
• Rachel Smith
• Reilly Smith
• Stanley S Smith, PH.D.
• Angela M Snyder, LISW
• Heather Snyder
• Thomas John Snyder, DO
• Rebecca Anne Solomon, NP-C
• Betsy Sommer, LISW

• General Practice Dentistry in Davenport, IA
• Providers in Davenport, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; 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.