Tyrone Smith, DDS, MS

Primary specialty

DentistTaxonomy code 122300000X

License

12011536A Issued in IN

Practice address

10010 Dupont Circle CT
Fort Wayne, IN 46825-1626

Phone

(260) 490-9949

Fax

(260) 490-3199

NPI assigned

Sep 24, 2010

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

Enrolled in IN

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

Credentials

Master of Science

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.

• R M & M R Stetzel DDS Inc

  • General Practice Dentistry
  • Fort Wayne, IN
  • NPI 1356463327
  NPD (past)

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1548579592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 DUPONT CIRCLE CT.",
            "address_2": "STETZEL DENTAL GROUP",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46825",
            "telephone_number": "260-490-9949",
            "fax_number": "260-490-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 DUPONT CIRCLE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251626",
            "telephone_number": "260-490-9949",
            "fax_number": "260-490-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TYRONE",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-24",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011536A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne M Smith, PA-C
• Thomas Robert Smith, PHARMD
• Tina Smith
• Traci Smith
• Treva E Smith, BCBA
• Yvonne Smith, LCSW
• Zachary D Smith, PHARMD
• Sarah Jeanne Smither, M.A., CFY-SLP
• Amanda Marie Smithson, COTA
• William Lee Smits, M.D.

• Dentist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; 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.