Individual provider Active NPI

Thomas Smithers

  • General Practice Dentistry
  • Berkeley, CA
National Provider Identifier
1285743013
Registry record updated Aug 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
32766 Issued in CA
Practice address
2300 Durant Ave
Berkeley, CA 94704-1607
Phone
(510) 843-2902
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2007

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 32766 CA Primary

Addresses

Primary practice location

2300 Durant Ave
Berkeley, CA 94704-1607

Mailing address

2300 Durant Ave
Berkeley, CA 94704-1607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
32766CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187913600000",
    "number": "1285743013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 DURANT AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 DURANT AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041607",
            "telephone_number": "510-843-2902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITHERS",
        "first_name": "THOMAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "32766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.