Individual provider Active NPI

McKenzie Smith, DMD

  • Dentist
  • Whitesburg, KY
National Provider Identifier
1619460714
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10116 Issued in KY
Practice address
226 Medical Plaza LN
Whitesburg, KY 41858-7425
Phone
(606) 633-4871
Fax
(606) 633-0883
NPI assigned
Jun 13, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10116 KY Primary

Addresses

Primary practice location

226 Medical Plaza LN
Whitesburg, KY 41858-7425

Mailing address

PO Box 40
Whitesburg, KY 41858-0040
Phone (606) 633-4823

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180816002338 KY Order and Referring Only - DentistPractitioner - Dentist 1951650472

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: mckenzie.smith.p1@direct.mtncomp.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1619460714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "WHITESBURG",
            "state": "KY",
            "postal_code": "418580040",
            "telephone_number": "606-633-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 MEDICAL PLAZA LN",
            "city": "WHITESBURG",
            "state": "KY",
            "postal_code": "418587425",
            "telephone_number": "606-633-4871",
            "fax_number": "606-633-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MCKENZIE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitesburg, KY

Sources for this page

Verify at the official NPI Registry.