John Lee Smith, MS, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

0401417676 Issued in VA

Practice address

13916 Metrotech Dr
Chantilly, VA 20151-3238

Phone

(703) 488-9922

NPI assigned

Sep 24, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784332800000",
    "number": "1356012702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13916 METROTECH DR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201513238",
            "telephone_number": "703-946-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13916 METROTECH DR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201513238",
            "telephone_number": "703-488-9922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1331 Pennsylvania Ave NW Ste 502",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200041771",
            "country_code": "US",
            "telephone_number": "202-347-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHN",
        "middle_name": "LEE",
        "credential": "MS, DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-24",
        "last_updated": "2026-07-18",
        "certification_date": "2026-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401417676",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "DC",
            "license": "DEN2000471",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Periodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2026; 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.