Johnny Lee Smith, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4489 Issued in AZ

Practice address

9276 W Union Hills Dr
Ste. a
Peoria, AZ 85382-8158

Phone

(623) 972-6137

Fax

(623) 972-6334

NPI assigned

Jun 30, 2005

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Westbrook Dental Center, P.a.

  • General Practice Dentistry
  • Peoria, AZ
  • NPI 1982248084
  NPD (past) Authorized official

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1629075130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9276 W UNION HILLS DR",
            "address_2": "STE. A",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853828158",
            "telephone_number": "623-972-6137",
            "fax_number": "623-972-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9276 W UNION HILLS DR",
            "address_2": "STE. A",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853828158",
            "telephone_number": "623-972-6137",
            "fax_number": "623-972-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JOHNNY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "4489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Smith
• Chastina Smith, SPLA
• Dorothy E Smith, DNP, RN, FNP-BC
• Erika Nikole Smith, PA-C
• Jessica Carmen Smith, BSN, RN
• Kerry Smith
• Lori Smith, LPC
• Madison Rose Smith, PT, DPT
• Shane Ray Smith, FNP-C
• Shiona Marie Smith, PA-C

• General Practice Dentistry in Peoria, AZ
• Providers in Peoria, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.