Kenneth R Smith D. O. P.C.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

1718 Issued in AZ

Legal business name

KENNETH R SMITH D. O. P.C.

Practice address

6040 N 43Rd Ave
Suite 1
Glendale, AZ 85301-5488

Phone

(623) 931-2221

NPI assigned

Jan 29, 2007

Organization subpart

No

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

Authorized official

Name

Kenneth R Smith, D.O.

Title

President

Phone

(623) 931-2221

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407992381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 N 43RD AVE",
            "address_2": "SUITE 1",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853015488",
            "telephone_number": "623-931-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 N 43RD AVE",
            "address_2": "SUITE 1",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853015488",
            "telephone_number": "623-931-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH R SMITH D. O. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-931-2221",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "AZ",
            "license": "1718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelvin Ngo DMD & Associates, PLLC (A Wink and A Smile of AZ)
• Lori A Kemper, D.O.
• Katherine Ann Kennedy
• Paula Kennedy
• Kenneth Burck DC
• Julie A Kenny, O.T.
• Tiffany Dawn Kenny, OCCUPATIONAL THERAPI
• Melissa Walkingshaw Kent
• Scott Ryan Kent, RN
• Valerie Leah Kent, MD

• Adult Medicine Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Adult Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.