Grant Smith, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901601457 Issued in MI

Practice address

962 Old M 66 NW
Kalkaska, MI 49646-8643

Phone

(231) 258-9061

NPI assigned

Jul 8, 2022

Last updated

Apr 9, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Smith Dentistry PLLC

  • General Practice Dentistry
  • Kalkaska, MI
  • NPI 1043065030
  NPD Authorized official

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1285367003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6455 E LINGAUR RD",
            "city": "LAKE LEELANAU",
            "state": "MI",
            "postal_code": "496539541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "962 OLD M 66 NW",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496468643",
            "telephone_number": "231-258-9061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5011 Skyview Ct",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496847150",
            "country_code": "US",
            "telephone_number": "231-947-3530",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "135 S Bowery Ave",
            "address_purpose": "LOCATION",
            "city": "Gladwin",
            "state": "MI",
            "postal_code": "486242013",
            "country_code": "US",
            "telephone_number": "989-796-4848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GRANT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-08",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601457",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901601457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Sheerin, PA-C
• Shopko Stores Operating Co LLC (Shopko Pharmacy 2656)
• Jacqueline Shumaker, RN, BSN, MPH
• Clayton G Skrzypczak, O.D.
• Smith Dentistry PLLC
• Perry Scott Smith, D.C.
• Ashley Lynn Snyder, RD
• Dan F. Soenen, D.D.S.,P.C.
• Jacob Soenen
• Kathleen D Steele, RN

• General Practice Dentistry in Kalkaska, MI
• Providers in Kalkaska, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.