Tamara Smith, D.D.S., M.S.D

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D12904 Issued in MN

Practice address

4187 161St LN NW
Andover, MN 55304-2274

Phone

(651) 303-8041

Fax

(651) 303-8041

NPI assigned

Jul 28, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Blaine Orthodontics

  • Dental Clinic/Center
  • Blaine, MN
  • NPI 1659031854
  NPD Authorized official
• White Bear Lake Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • White Bear Lake, MN
  • NPI 1730782467
  NPD Authorized official

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

{
    "created_epoch": "1311811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1376821157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4187 161ST LN NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553042274",
            "telephone_number": "651-303-8041",
            "fax_number": "651-303-8041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4187 161ST LN NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553042274",
            "telephone_number": "651-303-8041",
            "fax_number": "651-303-8041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TAMARA",
        "credential": "D.D.S., M.S.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-28",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "D12904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hawa Dekontee Sirleaf-Harris
• Courtney Jo Smith, PHARMD
• Jeffrey E Smith, OD
• Jodi Ann Smith, M.S., LMFT
• Joshua Smith, DPT
• Hannah Smoker, DPT
• Roman P Smulka, MD
• Laura Snell, M.A., OTR/L
• Sarah Sneltjes, DPT
• Kayla Evelyn Sorlie

• Orthodontics and Dentofacial Orthopedics Dentistry in Andover, MN
• Providers in Andover, MN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; 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.