NPIMap

Organization Active NPI

Steven W. Smith DDS PLLC

  • General Practice Dentistry
  • Sneads Ferry, NC
National Provider Identifier
1679930408
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9597 Issued in NC
Legal business name
STEVEN W. SMITH DDS PLLC
Practice address
1112 NC Highway 210
Sneads Ferry, NC 28460-9139
Phone
(910) 741-1555
NPI assigned
Jan 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Authorized official

Name
Mrs. Kenna Smith
Title
Office Manager
Phone
(910) 741-1555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 9597 NC Primary

Addresses

Primary practice location

1112 NC Highway 210
Sneads Ferry, NC 28460-9139

Mailing address

1112 NC Highway 210
Sneads Ferry, NC 28460-9139
Phone (910) 741-1555

Other identifiers 1

IdentifierTypeStateIssuer
1942430467MedicaidNC

Other names 1

  • Smith Family and Cosmetic Dentistry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160606000755 NC Part B Supplier - Clinic/Group Practice 4688964554 Receives reassigned benefits from 1 practitioner
Practice locations: Sneads Ferry, NC

National Provider Directory

National Provider Directory

Locations

1112 NC Highway 210
Sneads Ferry, NC 28460
Phone (910) 741-1555

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1679930408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 NC HIGHWAY 210",
            "city": "SNEADS FERRY",
            "state": "NC",
            "postal_code": "284609139",
            "telephone_number": "910-741-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 NC HIGHWAY 210",
            "city": "SNEADS FERRY",
            "state": "NC",
            "postal_code": "284609139",
            "telephone_number": "910-741-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN W. SMITH DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KENNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-741-1555",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942430467",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smith Family and Cosmetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sneads Ferry, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.