Individual provider Active NPI

Christopher A Smith, DMD

  • General Practice Dentistry
  • Edmonds, WA
National Provider Identifier
1679769087
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00011098 Issued in WA
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, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160808001027 WA Order and Referring Only - Oral SurgeryPractitioner - 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

Verify at the official NPI Registry.