Organization Active NPI

Richard M. Smith, DDS, PC

  • Dentist
  • Amarillo, TX
National Provider Identifier
1366609075
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21684 Issued in TX
Legal business name
RICHARD M. SMITH, DDS, PC
Practice address
3611 S Georgia St
Amarillo, TX 79109-4847
Phone
(806) 353-4361
Fax
(806) 353-4767
NPI assigned
May 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Dr. Richard Madsen Smith, DDS
Title
President
Phone
(806) 353-4361

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 9826 TX
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 21684 TX Primary

Addresses

Primary practice location

3611 S Georgia St
Amarillo, TX 79109-4847

Mailing address

3611 S Georgia St
Amarillo, TX 79109-4847
Phone (806) 353-4361

Other identifiers 5

IdentifierTypeStateIssuer
1903734-01MedicaidTX
G60178-1OtherTXTEXAS CHIP
0095648-01MedicaidTX
1023234606OtherNPI
1730305582OtherNPI

National Provider Directory

National Provider Directory

Locations

3611 S Georgia St
Amarillo, TX 79109
Phone (806) 353-4361

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1366609075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 S GEORGIA ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791094847",
            "telephone_number": "806-353-4361",
            "fax_number": "806-353-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 S GEORGIA ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791094847",
            "telephone_number": "806-353-4361",
            "fax_number": "806-353-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD M. SMITH, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "MADSEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "806-353-4361",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "9826",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "21684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1903734-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS CHIP",
            "identifier": "G60178-1",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0095648-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1023234606",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1730305582",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.