Jennifer Nicole Smith, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30186 Issued in TX

Practice address

1107 E Marshall Ave
Longview, TX 75601-5602

Phone

(903) 758-2610

Fax

(903) 758-7081

NPI assigned

Jul 3, 2014

Sex

Female

Sole proprietor

No

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

Enrolled in TX

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifersmith@wp.medalliesdirect.net

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.

• Longview Wellness Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
  • NPI 1942269493

  General Practice

  Medicare reassignment NPD
• Longview Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
  • NPI 1255137659
  NPD
• Longview Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Mt Pleasant, TX
  • NPI 1821633033
  NPD
• Longview Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Longview, TX
  • NPI 1447910542
  NPD (past)

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1396151817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015602",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015602",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Titus St Ste 130",
            "address_purpose": "LOCATION",
            "city": "Gilmer",
            "state": "TX",
            "postal_code": "756441780",
            "country_code": "US",
            "telephone_number": "903-758-2610",
            "fax_number": "903-758-7081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-03",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "30186",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "30186",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Wisdom Smith, APRN, PMHNP-BC
• Alyssa T Smith, DPT
• Carlton Smith, LCDC
• Christina Renee Smith
• Delisa Christine Smith, LCSW
• Malia Smith
• Mary Beth Smith, CNM
• Mary Bob Smith, LPC
• Michael L. Smith, PA-C
• Neva Smith

• General Practice Dentistry in Longview, TX
• Providers in Longview, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.