Jesse Smith, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2018017556 Issued in MO

Practice address

441 Marshall Dr
Saint Robert, MO 65584

Phone

(573) 336-5599

NPI assigned

May 30, 2018

Last updated

Jun 1, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Practice roles

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

• Jesse Smith DDS LLC

  dba Saint Robert Family Dental Center

  • Dental Clinic/Center
  • Saint Robert, MO
  • NPI 1841778123
  NPD (past) Authorized official
• Kiersz Dentistry Inc

  dba St. Robert Family Dental Center

  • General Practice Dentistry
  • Saint Robert, MO
  • NPI 1366597197
  NPD (past)

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1508358177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 MARSHALL DR",
            "city": "SAINT ROBERT",
            "state": "MO",
            "postal_code": "655845603",
            "telephone_number": "573-336-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 MARSHALL DR",
            "city": "SAINT ROBERT",
            "state": "MO",
            "postal_code": "65584",
            "telephone_number": "573-336-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2018017556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Mechelleleigh Shoffner
• Chrissie Silva, LMSW
• Heather Simpson
• Karen Siu
• Alexia Lynn Smith
• Lucinda Snyder
• South Central Missouri Community Health Center
• South Central Missouri Community Health Center
• Squared Away Veterans Express (Save)
• St. Robert Chiropractic Center, Inc

• Dentist in Saint Robert, MO
• Providers in Saint Robert, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; 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.