Craig Lamont Smith, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5426-015 Issued in WI

Practice address

1345 W Towne Square Rd
Mequon, WI 53092-5047

Phone

(262) 242-1180

Fax

(262) 236-9079

NPI assigned

Jul 28, 2005

Last updated

Jan 2, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 22, 2015 through Apr 22, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Shore Dental, LLC

  • General Practice Dentistry
  • Mequon, WI
  • NPI 1932445442
  Authorized official Same address or phone

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1316947690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 W TOWNE SQUARE RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925047",
            "telephone_number": "262-242-1180",
            "fax_number": "262-236-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 W TOWNE SQUARE RD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925047",
            "telephone_number": "262-242-1180",
            "fax_number": "262-236-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CRAIG",
        "middle_name": "LAMONT",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "6010",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5426-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "860967",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ross M Skizycki, M.D.
• Sleep Services of Wisconsin, LLC (The Sleep Wellnes Institute)
• Sleep Wellness Institute, Inc (Cpap2Go)
• Smart Choice MRI, LLC (Smart Choice MRI Glenview)
• Smart Choice MRI, LLC (Smart Choice MRI Woodbury)
• Darrin Smith
• Emily Smith, M.S., CCC-SLP
• Kelly Payne Smith, NP
• Naquisha Nashae Smith
• Olivia L Smith, BCBA

• General Practice Dentistry in Mequon, WI
• Providers in Mequon, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.