Individual provider Active NPI

Duane A Smith, D.D.S.

  • General Practice Dentistry
  • Webster City, IA
National Provider Identifier
1407941529
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6470 Issued in IA
Practice address
803 Ohio St
Webster City, IA 50595-2850
Phone
(515) 832-3313
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6470 IA Primary

Addresses

Primary practice location

803 Ohio St
Webster City, IA 50595-2850

Mailing address

PO Box 124
Webster City, IA 50595-0124
Phone (515) 832-3313

Other identifiers 1

IdentifierTypeStateIssuer
0162867MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20150615000880 IA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3779894969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6470IAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1407941529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 124",
            "city": "WEBSTER CITY",
            "state": "IA",
            "postal_code": "505950124",
            "telephone_number": "515-832-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 OHIO ST",
            "city": "WEBSTER CITY",
            "state": "IA",
            "postal_code": "505952850",
            "telephone_number": "515-832-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DUANE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "6470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0162867",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster City, IA

Sources for this page

Verify at the official NPI Registry.