Jacqueline Brown Smith, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

0401411605 Issued in VA

Practice address

621 Lynnhaven Pkwy Ste 255
Virginia Beach, VA 23452-7383

Phone

(757) 738-2981

Fax

(757) 424-2226

NPI assigned

Nov 28, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1396811451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 LEARY CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233236687",
            "telephone_number": "757-558-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 LYNNHAVEN PKWY STE 255",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527383",
            "telephone_number": "757-738-2981",
            "fax_number": "757-424-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACQUELINE",
        "middle_name": "BROWN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7330",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "899018V",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hollis Mackenzie Smith
• Howard Clayton Smith Jr., M.D.
• Ian Everett Smith
• Imani M Smith, LPC
• Jacob Smith, DO
• Jacqueline Rae Smith, RBT, QMHPC
• James Ellis Smith, DC
• Jaquana Smith
• Jeffrey P Smith, MD
• Jennifer Nicole Smith

• Dentist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.