Justin R Smith, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN19194 Issued in FL

Practice address

2407 Saint Andrews Blvd Ste a
Panama City, FL 32405-2170

Phone

(850) 763-5021

NPI assigned

Aug 25, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Justin R Smith DMD PA

  • General Practice Dentistry
  • Panama City, FL
  • NPI 1215659776
  NPD (past)

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1497061634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2407 SAINT ANDREWS BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324052170",
            "telephone_number": "850-763-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2407 SAINT ANDREWS BLVD STE A",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324052170",
            "telephone_number": "850-763-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JUSTIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-25",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "D0005975-C1",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 19194",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN19194",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Smith, LMT
• Elizabeth Smith
• Hina Smith, M.D.
• Isabella Davida Agudo Smith
• Jennifer Smith, LPN
• Katie L Smith, APRN
• Kelly A Smith, O.D.
• Laura Suzanne Smith, BS - INFANT TODDLER
• Leslie Smith, HAS
• Lolita Ann Smith, M.S., CAP, CMHP LMHC

• Dentist in Panama City, FL
• Providers in Panama City, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.