NPIMap

Organization Active NPI

Maumelle Family Dental Care

  • General Practice Dentistry
  • Maumelle, AR
National Provider Identifier
1619133279
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2648 Issued in AR
Legal business name
MAUMELLE FAMILY DENTAL CARE
Doing business as
Keith W. Smith, D.D.S.
Practice address
301 Millwood Cir
Suite 107
Maumelle, AR 72113-6319
Phone
(501) 851-7645
Fax
(501) 851-4281
NPI assigned
Aug 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Authorized official

Name
Dr. Keith Wayne Smith, D.D.S.
Title
General Dentist
Phone
(501) 851-7645

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2648 AR Primary

Addresses

Primary practice location

301 Millwood Cir
Suite 107
Maumelle, AR 72113-6319

Mailing address

301 Millwood Cir
Suite 107
Maumelle, AR 72113-6319
Phone (501) 851-7645

Other identifiers 3

IdentifierTypeStateIssuer
5T895OtherARBLUE CROSS BLUE SHIELD
975050OtherUNITED CONCORDIA
995157OtherCOMPBENEFITS

Other names 1

  • Keith W. Smith, D.D.S. Doing business as

National Provider Directory

National Provider Directory

Locations

301 Millwood Cir
Ste 107
Maumelle, AR 72113
Phone (501) 851-7645

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1619133279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MILLWOOD CIR",
            "address_2": "SUITE 107",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721136319",
            "telephone_number": "501-851-7645",
            "fax_number": "501-851-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MILLWOOD CIR",
            "address_2": "SUITE 107",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721136319",
            "telephone_number": "501-851-7645",
            "fax_number": "501-851-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUMELLE FAMILY DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-04",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "501-851-7645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5T895",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "975050",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPBENEFITS",
            "identifier": "995157",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keith W. Smith, D.D.S.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maumelle, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.