Active NPI
Michael Smith, DDS
- Dentist
- Escondido, CA
National Provider Identifier
1386252179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 111198
- Practice address
- 726 E Grand Ave Ste a
Escondido, CA 92025-4446 - Phone
- (760) 747-2616
- NPI assigned
- Jul 17, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2020021103 | MO | |
| Dentist | 122300000X | 111198 | CA | Primary |
Addresses
Primary practice location
726 E Grand Ave Ste a
Escondido, CA 92025-4446
Mailing address
2410 Sampson St
North Chicago, IL 60088-2942
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111198 | CA | MD | Dentist |
| 2020021103 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750204800000",
"number": "1386252179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2410 SAMPSON ST",
"city": "NORTH CHICAGO",
"state": "IL",
"postal_code": "600882942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "726 E GRAND AVE STE A",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920254446",
"telephone_number": "760-747-2616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-17",
"last_updated": "2025-06-18",
"certification_date": "2025-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2020021103",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "111198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Escondido, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.