Individual provider Active NPI

Edward Angus Jackson Smith, D.D.S.

  • Dentist
  • Savannah, GA
National Provider Identifier
1568183473
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN122890 Issued in GA
Practice address
5102 Paulsen St BLDG 8
Savannah, GA 31405-4624
Phone
(912) 655-8855
Fax
(912) 335-6564
NPI assigned
Sep 8, 2022
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN122890 GA Primary
Dentist 122300000X DN27476 FL
Dentist 122300000X 10315 SC
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN122890 GA
Interventional Pain Medicine Physician 208VP0014X DN122890 GA

Addresses

Primary practice location

5102 Paulsen St BLDG 8
Savannah, GA 31405-4624

Mailing address

5102 Paulsen St BLDG 8
Savannah, GA 31405-4624
Phone (912) 655-8855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN27476FLMDDentist
DN122890GAMDDentist
10315SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Doug Smith DDS Orthodontics LLC Orthodontics and Dentofacial Orthopedics Current Accepting new patients
Savannah Sleep Consultants LLC Orthodontics and Dentofacial Orthopedics Current Accepting new patients

Locations

5102 Paulsen St
Bldg 8
Savannah, GA 31405
Phone (912) 500-5094

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1568183473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5102 PAULSEN ST BLDG 8",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054624",
            "telephone_number": "912-655-8855",
            "fax_number": "912-335-6564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5102 PAULSEN ST BLDG 8",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054624",
            "telephone_number": "912-655-8855",
            "fax_number": "912-335-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EDWARD",
        "middle_name": "ANGUS JACKSON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-08",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN122890",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN27476",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "10315",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN122890",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "DN122890",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; 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.