NPIMap

Organization Active NPI

Paul D Smith D.D.S., S.C. Dba Jackson Park Family Dental

  • Dentist
  • Milwaukee, WI
National Provider Identifier
1558023622
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PAUL D SMITH D.D.S., S.C. DBA JACKSON PARK FAMILY DENTAL
Practice address
3520 W Oklahoma Ave
Milwaukee, WI 53215-4175
Phone
(414) 645-0365
NPI assigned
Oct 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Authorized official

Name
Dr. Daniel SmithNPI 1972881787
Title
Practice Partner
Phone
(414) 645-0365

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

3520 W Oklahoma Ave
Milwaukee, WI 53215-4175

Mailing address

3520 W Oklahoma Ave
Milwaukee, WI 53215-4175
Phone (414) 645-0365

Other names 1

  • Paul Smith DDS Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Smiles@jpfamilydental.com Direct
Direct Messaging Address contact@jpfamilydental.com Direct

National Provider Directory

National Provider Directory

Locations

3520 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 645-0365

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1558023622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154175",
            "telephone_number": "414-645-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154175",
            "telephone_number": "414-645-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL D SMITH D.D.S., S.C. DBA JACKSON PARK FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-06",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRACTICE PARTNER",
        "authorized_official_telephone_number": "414-645-0365",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Smiles@jpfamilydental.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3520 W Oklahoma Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154175",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@jpfamilydental.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct",
            "address_1": "3520 W Oklahoma Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Paul Smith DDS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Paul Smith DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.