Kevin Stewart Smith, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4894 Issued in OK

Practice address

1000 N Lincoln Blvd
Ste 200
Oklahoma City, OK 73104-3252

Phone

(405) 271-4955

Fax

(405) 271-4525

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2012 through Oct 1, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Wisdom Tooth Center, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Moore, OK
  • NPI 1801303888
  NPD (past) Authorized official
• Sullivan, Tiwana, & Ritto Oral & Maxillofacial Surgery Partnership

  • Oral and Maxillofacial Surgery (Dentist)
  • Oklahoma City, OK
  • NPI 1952401796
  NPD
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396785481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N LINCOLN BLVD",
            "address_2": "STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731043252",
            "telephone_number": "405-271-4955",
            "fax_number": "405-271-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N LINCOLN BLVD",
            "address_2": "STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731043252",
            "telephone_number": "405-271-4955",
            "fax_number": "405-271-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KEVIN",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "4894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100824870A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelli Marie Smith
• Kellie Danielle Smith, FNP
• Kelly Smith
• Kenneth R Smith, M.D.
• Keri Doneece Smith, D.O.
• Ki Makenzi Smith, PHARMD
• Kimberly S Smith, M.D.
• Kristen Smith
• Kristie Alana Smith, LPN
• Lacy Brooke Smith, ARNP, CPNP-AC

• Oral and Maxillofacial Surgery (Dentist) in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.