Andrea Joy Smith

Primary specialty

DentistTaxonomy code 122300000X

License

42499 Issued in CA

Practice address

4301 El Camino Ave
Sacramento, CA 95821-6701

Phone

(916) 482-8300

Fax

(916) 482-2043

NPI assigned

Apr 21, 2006

Sex

Female

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective Oct 17, 2023 through Oct 17, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1386600252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 EL CAMINO AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958216701",
            "telephone_number": "916-482-8300",
            "fax_number": "916-482-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 EL CAMINO AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958216701",
            "telephone_number": "916-482-8300",
            "fax_number": "916-482-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANDREA",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "42499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia Marie Smith
• Amy Allison Smith
• Amy Ann Smith, LCSW, MSW, BSW
• Amy Joy Smith
• Andrea Smith
• Angel Smith
• Angela Dee Smith
• Angela Michelle Smith, P.T.
• Anisah Elise Smith
• Ann Frances Smith, FNP

• Dentist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.