Jessica Smith, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901023209 Issued in MI

Practice address

294 Nelson Rd
Ludington, MI 49431-1942

Phone

(231) 843-4255

NPI assigned

Jun 5, 2019

Last updated

Mar 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Jessica Larson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Smith and Larson Family Dentistry, PLLC

  • Dentist
  • Ludington, MI
  • NPI 1669120838
  NPD Authorized official
• Cheryl Larson, D.D.S. & Associates, PLLC

  • General Practice Dentistry
  • Ludington, MI
  • NPI 1568072213
  NPD (past)

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1619535416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 NELSON RD",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311942",
            "telephone_number": "231-843-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 NELSON RD",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311942",
            "telephone_number": "231-843-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901023209",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901023209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LARSON",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julie Lynn Skupien, P.T.A.
• Caylee Skvarenina
• Daniel R Smalley, DO
• Matthew D Smekar, LPC
• Smith and Larson Family Dentistry, PLLC
• Shannon Snider, LMSW
• Snug Harbor Adult Day Care Center
• Joshua Snyder, LPC
• Briana Somero, OTRL
• Bethany Ann Sommerfeldt, RD

• General Practice Dentistry in Ludington, MI
• Providers in Ludington, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.