Andrew Smith, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE61175335 Issued in WA

Practice address

19657 Wa-410
Bonney Lake, WA 98391

Phone

(253) 780-7003

NPI assigned

Jul 28, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1487327219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16306 107TH CT SE",
            "city": "YELM",
            "state": "WA",
            "postal_code": "985977652",
            "telephone_number": "360-481-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19657 WA-410",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "98391",
            "telephone_number": "253-780-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANDREW",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61175335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akanksha Singh
• Francisca Maria Siriwardana, LPN
• Jeff Lee Sisco, LMP
• Thomas Nicholas Skarshaug, DDS
• Kirk Allen Skidmore, DDS
• Karen Sue Smith, D.C.
• Michelle M Smith, OT
• Sound Pain Alliance
• Sound Pain Alliance
• Kacy Spooner, MOT

• General Practice Dentistry in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.