Organization Active NPI

D Raleigh Smith DMD, PLLC

  • Dentist
  • Pueblo, CO
National Provider Identifier
1417624420
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
D RALEIGH SMITH DMD, PLLC
Doing business as
Pueblo Dental
Practice address
1345 S Pueblo Blvd
Pueblo, CO 81005-1508
Phone
(719) 542-3595
NPI assigned
Aug 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Authorized official

Name
Rachel Meares
Title
Operations Manager
Phone
(719) 542-3595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1345 S Pueblo Blvd
Pueblo, CO 81005-1508

Mailing address

1345 S Pueblo Blvd
Pueblo, CO 81005-1508
Phone (719) 542-3595

Other identifiers 1

IdentifierTypeStateIssuer
1740666007OtherINDIVIDUAL NPI (TYPE 1)

Other names 1

  • Pueblo Dental Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address office@mypueblodentist.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

1345 S Pueblo Blvd
Pueblo, CO 81005
Phone (623) 910-5569

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": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1417624420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 S PUEBLO BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810051508",
            "telephone_number": "719-542-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 S PUEBLO BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810051508",
            "telephone_number": "719-542-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D RALEIGH SMITH DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "MEARES",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "719-542-3595"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI (TYPE 1)",
            "identifier": "1740666007",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@mypueblodentist.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1345 S Pueblo Blvd",
            "city": "Pueblo",
            "state": "CO",
            "country_code": "US",
            "postal_code": "810051508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pueblo Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.