Organization Active NPI

Smith and Ingersoll, Raleigh NC, PLLC

  • Dentist
  • Raleigh, NC
National Provider Identifier
1417358573
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5261 Issued in NC
Legal business name
SMITH AND INGERSOLL, RALEIGH NC, PLLC
Practice address
200 Sawmill Road
Suite 100
Raleigh, NC 27615
Phone
(919) 847-5283
NPI assigned
Sep 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Authorized official

Name
Dr. Jacob Thomas Smith, DDS
Title
M
Phone
(919) 847-5283

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 9665 NC
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 9695 NC
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 9696 NC
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 5261 NC Primary
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X 9664 NC

Addresses

Primary practice location

200 Sawmill Road
Suite 100
Raleigh, NC 27615

Mailing address

200 Sawmill Rd Ste 100
Raleigh, NC 27615-5275
Phone (919) 847-5283

Other names 1

  • Royal Oak Dental Group at Midtown Doing business as

National Provider Directory

National Provider Directory

Locations

200 Sawmill Rd
Ste 100
Raleigh, NC 27615
Phone (919) 847-5283

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410220800000",
    "number": "1417358573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SAWMILL RD STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276155275",
            "telephone_number": "919-847-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SAWMILL ROAD",
            "address_2": "SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27615",
            "telephone_number": "919-847-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH AND INGERSOLL, RALEIGH NC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "last_updated": "2014-09-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "M",
        "authorized_official_telephone_number": "919-847-5283",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "9665",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "9695",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "9696",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "5261",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "NC",
            "license": "9664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Royal Oak Dental Group at Midtown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; 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.