Active NPI
Christopher A Smith, DMD
- General Practice Dentistry
- Edmonds, WA
National Provider Identifier
1679769087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE00011098
- Practice address
- 23320 Highway 99
Edmonds, WA 98026-8744 - Phone
- (425) 640-5500
- Fax
- (425) 640-5534
- NPI assigned
- Sep 19, 2007
- Last updated
- Jul 15, 2021
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE00011098 | WA | Primary |
Addresses
Primary practice location
23320 Highway 99
Edmonds, WA 98026-8744
Mailing address
23320 Highway 99
Edmonds, WA 98026-8744
Phone (425) 640-5500
Other practice location 1
6135 Seaview Ave NW
Suite 2-E
Seattle, WA 98107-2628
Phone (206) 782-9183
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160808001027 | WA | Order and Referring Only - Oral Surgery | 3779877139 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626307200000",
"number": "1679769087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23320 HIGHWAY 99",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980268744",
"telephone_number": "425-640-5500",
"fax_number": "425-640-5534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23320 HIGHWAY 99",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980268744",
"telephone_number": "425-640-5500",
"fax_number": "425-640-5534"
}
],
"practiceLocations": [
{
"address_1": "6135 Seaview Ave NW",
"address_2": "Suite 2-E",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981072628",
"country_code": "US",
"telephone_number": "206-782-9183",
"fax_number": "206-784-7985",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "CHRISTOPHER",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-19",
"last_updated": "2021-07-15",
"certification_date": "2021-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE00011098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.