Michael R Smith, D.M.D.,P.A.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN13788 Issued in FL

Practice address

1520 Business Center Dr Ste 1
Orange Park, FL 32003-7480

Phone

(904) 637-0028

Fax

(866) 694-8463

NPI assigned

Mar 6, 2007

Sex

Male

Sole proprietor

Yes

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

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1285764860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 BUSINESS CENTER DR STE 1",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320037480",
            "telephone_number": "904-637-0028",
            "fax_number": "866-694-8463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 BUSINESS CENTER DR STE 1",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320037480",
            "telephone_number": "904-637-0028",
            "fax_number": "866-694-8463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "D.M.D.,P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN13788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Smith, MD
• Jessica Leigh Gleaton Smith, A.P., D.O.M.
• Kaitlyn L Smith, DPT
• Keiyuna Jikiara Smith
• Mary S Smith, SPECIALIST
• Rileigh May Smith
• Steven Smith, PT
• Social Care Services, LLC
• Hannah Sodergren, DO
• Susanna Sogge, DO

• Endodontics in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.