Active NPI
Luke Smith, DMD
- Dentist
- Cannon Afb, NM
National Provider Identifier
1649074964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8210
- Practice address
- 104 W D.L. Ingram Ave
Cannon Afb, NM 88101 - Phone
- (575) 784-4041
- NPI assigned
- Apr 3, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8210 | NV | Primary |
| Dentist | 122300000X | DB-2026-0225 | NM |
Addresses
Primary practice location
104 W D.L. Ingram Ave
Cannon Afb, NM 88101
Mailing address
104 W D.L. Ingram Ave
Cannon Afb, NM 88101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8210 | NV | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787011200000",
"number": "1649074964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 W D.L. INGRAM AVE",
"city": "CANNON AFB",
"state": "NM",
"postal_code": "88101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 W D.L. INGRAM AVE",
"city": "CANNON AFB",
"state": "NM",
"postal_code": "88101",
"telephone_number": "575-784-4041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "LUKE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-04-03",
"last_updated": "2026-08-18",
"certification_date": "2026-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "8210",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DB-2026-0225",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cannon Afb, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.