Jennifer Lee Smith, D160128721

Primary specialty

Dental AssistantTaxonomy code 126800000X

License

D160128721 Issued in WA

Practice address

3626 Factoria Blvd SE
Bellevue, WA 98006-6128

Phone

(425) 747-4695

NPI assigned

Dec 30, 2015

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1659736056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8102 48TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981184406",
            "telephone_number": "206-497-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3626 FACTORIA BLVD SE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980066128",
            "telephone_number": "425-747-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "D160128721",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "WA",
            "license": "D160128721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RDA",
            "identifier": "D160128721",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Smith
• Emily Q Smith, FNP
• Eric J Smith, MD
• Erin A Smith, CRNA
• Janice M Smith, LMHCA
• John W Smith, M.D.
• Keenan Smith, PMHNP-BC
• Kyleigh Lynn Marie Smith
• Kyrah A Smith
• Lem Michael Smith, M.D.

• Dental Assistant in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Dental Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.