Individual provider Active NPI

Jodie Smith, DMD

  • Dentist
  • Lindenhurst, NY
National Provider Identifier
1295315554
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
062616 Issued in NY
Practice address
60 Sunrise Hwy # 60
Lindenhurst, NY 11757-2505
Phone
(631) 296-1124
NPI assigned
Apr 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22D102878500 NJ
Dentist 122300000X 062616 NY Primary

Addresses

Primary practice location

60 Sunrise Hwy # 60
Lindenhurst, NY 11757-2505

Mailing address

462 First Avenue
New York, NY 10016

Other practice location 1

165 Ocean Ave
Jersey City, NJ 07305-3812
Phone (551) 554-3500

Other practice location 2

66 Somme St
Newark, NJ 07105-3612
Phone (973) 578-8788

Other practice location 3

65 Jefferson Ave
Elizabeth, NJ 07201-2474
Phone (908) 469-9100

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
22D102878500NJMDDentist
062616NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Ave Dental, LLC Dentist PastSince Jul 10, 2022 Accepting new patients

Organizations & group practices 1

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": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1295315554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 FIRST AVENUE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 SUNRISE HWY # 60",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117572505",
            "telephone_number": "631-296-1124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "165 Ocean Ave",
            "address_purpose": "LOCATION",
            "city": "Jersey City",
            "state": "NJ",
            "postal_code": "073053812",
            "country_code": "US",
            "telephone_number": "551-554-3500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "66 Somme St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071053612",
            "country_code": "US",
            "telephone_number": "973-578-8788",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "65 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Elizabeth",
            "state": "NJ",
            "postal_code": "072012474",
            "country_code": "US",
            "telephone_number": "908-469-9100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JODIE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D102878500",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.