Michael T Smith, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

019028833 Issued in IL

Practice address

16 N Jackson St
Belleville, IL 62220-1425

Phone

(618) 235-5141

Fax

(618) 235-2155

NPI assigned

Sep 1, 2011

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)

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.

• Michael Smith DMD, LLC

  • Dental Clinic/Center
  • Belleville, IL
  • NPI 1639679087
  NPD Authorized official

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614470400000",
    "number": "1649551748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 N JACKSON ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201425",
            "telephone_number": "618-235-5141",
            "fax_number": "618-235-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 N JACKSON ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201425",
            "telephone_number": "618-235-5141",
            "fax_number": "618-235-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-01",
        "last_updated": "2021-02-28",
        "certification_date": "2021-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen W Slone, ATC
• Smile Team, PC
• Caitlyn Morgan Smith, MA
• Carole K Smith, CRNA
• Cristine Smith, DDS
• Sara Marie Smith, PHARM.D.
• Sonya Smith, SLP
• Terri R Smith, LCSW
• Thomas Hamilton Smith, M.D.
• Jaclyn N Sneed, PA

• Dentist in Belleville, IL
• Providers in Belleville, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.