Individual provider Active NPI

Thomas M Smith, DDS

  • General Practice Dentistry
  • Muskegon, MI
National Provider Identifier
1346257086
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901015068 Issued in MI
Practice address
755 Seminole Rd
Suite 103
Muskegon, MI 49441-4721
Phone
(231) 780-5334
Fax
(231) 780-5335
NPI assigned
Aug 2, 2006
Last updated
Nov 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901015068 MI Primary

Addresses

Primary practice location

755 Seminole Rd
Suite 103
Muskegon, MI 49441-4721

Mailing address

755 Seminole Rd
Suite 103
Muskegon, MI 49441-4721
Phone (231) 780-5334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161018001641 MI Order and Referring Only - DentistPractitioner - Dentist 2668760034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas M Smith DDS PLC General Practice CurrentSince May 12, 2024 Accepting new patients
Thomas M Smith, DDS, PLC CurrentSince Nov 8, 2020 Accepting new patients

Locations

755 Seminole Rd
Ste 103
Norton Shores, MI 49441
Phone (231) 780-5334

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1346257086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 SEMINOLE RD",
            "address_2": "SUITE 103",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494414721",
            "telephone_number": "231-780-5334",
            "fax_number": "231-780-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 SEMINOLE RD",
            "address_2": "SUITE 103",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494414721",
            "telephone_number": "231-780-5334",
            "fax_number": "231-780-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901015068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.