Kerri Smith, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11500 Issued in OR

Practice address

11525 SW Durham Rd Ste D1
Tigard, OR 97224-3475

Phone

(503) 620-6133

NPI assigned

Jul 23, 2019

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

Medicare fee-for-service enrollment

Enrolled in UT

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

Medicare enrollment (NPD)

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.

• Kerri Smith, DMD, LLC

  • Dental Clinic/Center
  • Tigard, OR
  • NPI 1780369934

  General Practice

  NPD Authorized official
• Atwood, Strong, & Associates, PLLC

  • General Practice Dentistry
  • Spanish Fork, UT
  • NPI 1821789579
  NPD (past)

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1639722234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11525 SW DURHAM RD STE D1",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972243475",
            "telephone_number": "503-620-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11525 SW DURHAM RD STE D1",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972243475",
            "telephone_number": "503-620-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KERRI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "11369931-8903",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Smith
• Bradley George Smith, OD
• Danielle Marie Smith, CRM, PSS
• Dorothy L Smith, LMT
• Janell Smith
• Kirsten Breanna Smith
• Lacie Lynn Smith
• Leah Sue Smith
• Leanna Denay Smith
• Lindsey Smith, LMT

• General Practice Dentistry in Tigard, OR
• Providers in Tigard, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.