Gary L. Smith, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

14496 Issued in MO

Practice address

7600 Raytown Road
Suite 102
Raytown, MO 64138-1855

Phone

(816) 356-2445

Fax

(816) 356-3398

NPI assigned

Jan 16, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578614426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 RAYTOWN ROAD",
            "address_2": "SUITE 102",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641381855",
            "telephone_number": "816-356-2445",
            "fax_number": "816-356-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 RAYTOWN ROAD",
            "address_2": "SUITE 102",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641381855",
            "telephone_number": "816-356-2445",
            "fax_number": "816-356-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GARY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "14496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smile Care Raytown, LLC
• Smile Safari of Missouri
• Smileshack Missouri, LLC
• Aaron Nelson Smith, RD
• Charles P Smith, R.N.
• Lashae Smith, BSW MSW LMSW
• Caroline Song, MA, PLPC
• Jinming Song, MD
• Special People Requiring Unique Care Equally
• Spine & Extremity Rehabilitation Center of Raytown, Inc.

• Dentist in Raytown, MO
• Providers in Raytown, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.