NPIMap

Organization Active NPI

Dmitry Karagodsky PC

Doing business as Smile Maker

  • Oral and Maxillofacial Surgery (Dentist)
  • Southampton, PA
National Provider Identifier
1316711922
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
DMITRY KARAGODSKY PC
Doing business as
Smile Maker
Practice address
1775 Street Rd
Southampton, PA 18966-4564
Phone
(215) 969-2001
NPI assigned
Nov 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Authorized official

Name
Dmitry Karagodsky, DDSNPI 1992909261
Title
Authorized Official, Doctor
Phone
(215) 969-2015

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

1775 Street Rd
Southampton, PA 18966-4564

Mailing address

1775 Street Rd
Southampton, PA 18966-4564
Phone (215) 969-2001

Other names 1

  • SMILE MAKER Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699920000000",
    "number": "1316711922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 STREET RD",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189664564",
            "telephone_number": "215-969-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 STREET RD",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189664564",
            "telephone_number": "215-969-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DMITRY KARAGODSKY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-14",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A",
        "authorized_official_last_name": "KARAGODSKY",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL, DOCTOR",
        "authorized_official_telephone_number": "215-969-2015",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMILE MAKER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southampton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.