Active NPI
Emmett Smoak Ackermon Jr., DDS
- Dentist
- Youngsville, NC
National Provider Identifier
1316022700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5469
- Practice address
- 66 Wheaton Ave
Youngsville, NC 27596 - Phone
- (919) 488-0233
- Fax
- (919) 488-0234
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5469 | NC | Primary |
Addresses
Primary practice location
66 Wheaton Ave
Youngsville, NC 27596
Mailing address
PO Box 339
Franklinton, NC 27525
Phone (919) 488-0233
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8990052 | Medicaid | NC | |
| 5469 | Medicaid | NC |
Other names 1
- Emmett Smoak Ackermon
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5469 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| E.Smoak Ackerman PLLC | Dentist | Past | 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.
-
- Dentist
- Youngsville, NC
- NPI 1154503282
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1316022700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 339",
"city": "FRANKLINTON",
"state": "NC",
"postal_code": "27525",
"telephone_number": "919-488-0233",
"fax_number": "919-488-0234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 WHEATON AVE",
"city": "YOUNGSVILLE",
"state": "NC",
"postal_code": "27596",
"telephone_number": "919-488-0233",
"fax_number": "919-488-0234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACKERMON",
"first_name": "EMMETT",
"middle_name": "SMOAK",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "5469",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8990052",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5469",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "EMMETT",
"last_name": "ACKERMON",
"middle_name": "SMOAK",
"credential": "PLLC",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Youngsville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.