Demarcus D Smith IV, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

3596 Issued in LA

Practice address

4420 Conlin St
Suite 203
Metairie, LA 70006

Phone

(504) 455-9960

Fax

(504) 455-9961

NPI assigned

Sep 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Oral Surgery Services, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Metairie, LA
  • NPI 1598123978
  NPD (past) Authorized official

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

{
    "created_epoch": "1157760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306940556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 CONLIN ST",
            "address_2": "SUITE 203",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70006",
            "telephone_number": "504-455-9960",
            "fax_number": "504-455-9961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 CONLIN ST",
            "address_2": "SUITE 203",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70006",
            "telephone_number": "504-455-9960",
            "fax_number": "504-455-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DEMARCUS",
        "middle_name": "D",
        "name_suffix": "IV",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "3596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1835960",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Tuyen Smith
• Cody James Smith
• Davon Smith
• Deborah Grace Smith, DPH
• Deja Smith
• Ebony Smith, PHARMD
• Emily V Smith, CTRS
• Emoniiesha Smith
• Felicia Smith
• Frances Smith

• Oral and Maxillofacial Surgery (Dentist) in Metairie, LA
• Providers in Metairie, LA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.