Active NPI
Theresa Smith
- Periodontics
- Bensalem, PA
National Provider Identifier
1609938828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DS030610L
- Practice address
- 230 Neshaminy Mall
Bensalem, PA 19020-1600 - Phone
- (215) 355-2300
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DS030610L | PA | Primary |
Addresses
Primary practice location
230 Neshaminy Mall
Bensalem, PA 19020-1600
Mailing address
230 Neshaminy Mall
Bensalem, PA 19020-1600
Phone (215) 355-2300
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
| License | State | Type | Specialty |
|---|---|---|---|
| DS030610L | PA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609938828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 NESHAMINY MALL",
"city": "BENSALEM",
"state": "PA",
"postal_code": "190201600",
"telephone_number": "215-355-2300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 NESHAMINY MALL",
"city": "BENSALEM",
"state": "PA",
"postal_code": "190201600",
"telephone_number": "215-355-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "THERESA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "PA",
"license": "DS030610L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bensalem, PA
Sources for this page
- 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.