Benjamin Smith, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD198549 Issued in OR

Practice address

2605 State St
Salem, OR 97310-5000

Phone

(503) 378-2453

NPI assigned

May 8, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1538570874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "OREGON STATE PENITENTIARY 2605",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973105000",
            "telephone_number": "503-378-2453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973105000",
            "telephone_number": "503-378-2453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Naval Medical Ctr",
            "address_2": "34800 Bob Wilson Drive",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921345000",
            "country_code": "US",
            "telephone_number": "619-530-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BENJAMIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-08",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "VA",
            "license": "0101258753",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OR",
            "license": "MD198549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smith and Emerick Family Dental LLC
• Glenda Audrey Smith Fowler, AUD
• Alisha Smith, PSS
• Amy J. Smith, PH.D.
• Ashley Smith
• Bethany Smith
• Brandon Logan Smith
• Brent Edward Smith, DC
• Brian Smith
• Brittany Leigh Smith

• General Practice Physician in Salem, OR
• Providers in Salem, OR by specialty
• General Practice Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.