Kimberly Blair Smith, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3186-01 Issued in MS

Practice address

409 Main St N
Mendenhall, MS 39114-3318

Phone

(601) 847-1223

Fax

(601) 847-9131

NPI assigned

Jan 5, 2007

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kimberly Blair Smith DMD PA

  • Dental Clinic/Center
  • Mendenhall, MS
  • NPI 1891842332
  NPD (past) Authorized official

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649327164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 JAMES BERRY RD",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391115248",
            "telephone_number": "601-849-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 MAIN ST N",
            "city": "MENDENHALL",
            "state": "MS",
            "postal_code": "391143318",
            "telephone_number": "601-847-1223",
            "fax_number": "601-847-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KIMBERLY",
        "middle_name": "BLAIR",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3186-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0660390",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simpson Community Healthcare, Inc. (Simpson Community Healthcare, Inc. Cardiology)
• Simpson Community Healthcare, Inc. (Simpson Community Healthcare, Inc. Emergency Room)
• Simpson Community Healthcare, Inc. (Simpson Community Healthcare, Inc. Radiology)
• Simpson Dental Group PLLC
• Harpal Singh, M.D.
• Daniel Gregory Stevens, D.O.
• Whitney Stubbs, PH.D.
• Sweet Magnolia Staffing (Sweet Magnolia Staffing Solutions)
• Tajuana Thicklen
• Adrian Turner

• General Practice Dentistry in Mendenhall, MS
• Providers in Mendenhall, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.