Randall B Smith, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-3169 Issued in ID

Practice address

1848 S Millenium Way
Meridian, ID 83642

Phone

(208) 888-2026

Fax

(208) 888-2094

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

No

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

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 and National Provider Directory roles.

• Innovative Sleep & TMJ Center PLLC

  • General Practice Dentistry
  • Meridian, ID
  • NPI 1124892773
  NPD Authorized official
• McMillan Family Dental PLLC

  • Dental Clinic/Center
  • Meridian, ID
  • NPI 1275015950
  NPD Authorized official
• Millennium Family Dental - Meridian PLLC

  • General Practice Dentistry
  • Meridian, ID
  • NPI 1689773525
  NPD Authorized official

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1639264658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1848 S. MILLENNIUM WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-888-2026",
            "fax_number": "208-888-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1848 S MILLENIUM WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-888-2026",
            "fax_number": "208-888-2094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1720 W. McMillan Rd.",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "83646",
            "country_code": "US",
            "telephone_number": "208-888-2026",
            "fax_number": "208-888-2094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RANDALL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Smith, PHARMD
• Mark Ellsworth Smith, D.D.S. P.C.
• Mary Lynn Smith, RN
• Michael R Smith, NP-C
• Rachael Eve Smith, PNP-PC
• Rhonda M Smith, MS CCC-SLP
• Steven Alan Smith, M.D.
• Todd Robert Smith, MD
• Troy Alan Smith, DDS
• Zachary Smith, DMD

• General Practice Dentistry in Meridian, ID
• Providers in Meridian, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.