Active NPI
John David Smith, DR
- Dentist
- Bristol, FL
National Provider Identifier
1679567796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- LN3799
- Practice address
- 12832 NW Central Ave
Bristol, FL 32424 - Phone
- (850) 643-2415
- Fax
- (850) 643-5689
- NPI assigned
- Sep 2, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | LN3799 | AL | Primary |
Addresses
Primary practice location
12832 NW Central Ave
Bristol, FL 32424
Mailing address
834 Plantation Dr
Panama City, FL 32404-8629
Phone (850) 785-4522
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 |
|---|---|---|---|
| LN3799 | AL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1679567796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "834 PLANTATION DR",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324048629",
"telephone_number": "850-785-4522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12832 NW CENTRAL AVE",
"city": "BRISTOL",
"state": "FL",
"postal_code": "32424",
"telephone_number": "850-643-2415",
"fax_number": "850-643-5689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JOHN",
"middle_name": "DAVID",
"credential": "DR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-02",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AL",
"license": "LN3799",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristol, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.