Individual provider Active NPI

Stephen Emery Smith, DMD

  • General Practice Dentistry
  • Yelm, WA
National Provider Identifier
1275798746
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE60139830 Issued in WA
Practice address
718 Yelm Ave W Ste 3
Yelm, WA 98597-8764
Phone
(360) 458-5606
Fax
(360) 458-1948
NPI assigned
Jul 24, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE60139830 WA Primary

Addresses

Primary practice location

718 Yelm Ave W Ste 3
Yelm, WA 98597-8764

Mailing address

718 Yelm Ave W Ste 3
Yelm, WA 98597-8764
Phone (360) 458-5606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160204000275 WA Order and Referring Only - DentistPractitioner - Dentist 4183928633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen E. Smith DMD PLLC General Practice Past Accepting new patients
Nisqually Reach Family Dentistry PastSince Aug 25, 2019 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1275798746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 YELM AVE W STE 3",
            "city": "YELM",
            "state": "WA",
            "postal_code": "985978764",
            "telephone_number": "360-458-5606",
            "fax_number": "360-458-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 YELM AVE W STE 3",
            "city": "YELM",
            "state": "WA",
            "postal_code": "985978764",
            "telephone_number": "360-458-5606",
            "fax_number": "360-458-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHEN",
        "middle_name": "EMERY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-24",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60139830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yelm, WA

Sources for this page

Verify at the official NPI Registry.