Kevin Joseph Smith, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE 60171756 Issued in WA

Practice address

10001 NE 117TH Ave
Vancouver, WA 98662-1504

Phone

(402) 203-8776

NPI assigned

Jun 12, 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

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 and National Provider Directory roles.

• Ridgefield Dental Care LLC

  • Dentist
  • Ridgefield, WA
  • NPI 1457173007
  NPD (past) Authorized official

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1265636625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 S 8TH WAY",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986429237",
            "telephone_number": "402-203-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 NE 117TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986621504",
            "telephone_number": "402-203-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEVIN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE 60171756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan A Smith, DC
• Karen Smith
• Kateri Cheyenne Smith
• Kelly C Smith, D.C.
• Kepler Sage Smith, MSW
• Kiersten A Smith, MOTRL
• Leslie Smith, PHD
• Libbie Smith
• Linda H Smith, OTR/L
• Lonnie Rae Smith

• General Practice Dentistry in Vancouver, WA
• Providers in Vancouver, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.