NPIMap

Organization Active NPI

Larry V Smith DDS Inc

Doing business as Pacific Pediatric Dentistry

  • Pediatric Dentistry
  • San Luis Obispo, CA
National Provider Identifier
1457485583
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
LARRY V SMITH DDS INC
Doing business as
Pacific Pediatric Dentistry
Practice address
1231 Osos St
San Luis Obispo, CA 93401
Phone
(805) 544-3434
Fax
(805) 544-3443
NPI assigned
Mar 14, 2007
Last updated
Jul 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2007

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

Authorized official

Name
Larry V Smith, DDS MPHNPI 1679670277
Title
Dentist
Phone
(805) 544-3434

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

1231 Osos St
San Luis Obispo, CA 93401

Mailing address

1231 Osos St
San Luis Obispo, CA 93401
Phone (805) 544-3434

Other identifiers 1

IdentifierTypeStateIssuer
D18270OtherCADENTI-CAL

Other names 1

  • Pacific Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1457485583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 OSOS ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93401",
            "telephone_number": "805-544-3434",
            "fax_number": "805-544-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 OSOS ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93401",
            "telephone_number": "805-544-3434",
            "fax_number": "805-544-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY V SMITH DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "805-544-3434",
        "authorized_official_credential": "DDS MPH"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "D18270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; 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.