Individual provider Active NPI

Patricia Mary Smith, D.M.D.

  • Pediatric Dentistry
  • Newark, DE
National Provider Identifier
1689751265
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
G1-0001135 Issued in DE
Practice address
38 Peoples PLZ
Newark, DE 19702-4727
Phone
(302) 834-4000
NPI assigned
Nov 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X G1-0001135 DE Primary
Pediatric Dentistry 1223P0221X DS029356L PA
Pediatric Dentistry 1223P0221X DI 01930700 NJ

Addresses

Primary practice location

38 Peoples PLZ
Newark, DE 19702-4727

Mailing address

40 Waterview Dr
Pilesgrove, NJ 08098-2649
Phone (856) 769-3077

Other identifiers 1

IdentifierTypeStateIssuer
0001084108MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20150706000243 DE Order and Referring Only - DentistPractitioner - Dentist 7911196415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI 01930700NJMDPediatric Dentist
DS029356LPAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Collins Dental Ortho Inc Pediatric Dentistry PastSince Dec 31, 2023 Accepting new patients
Collins Dental LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689751265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 WATERVIEW DR",
            "city": "PILESGROVE",
            "state": "NJ",
            "postal_code": "080982649",
            "telephone_number": "856-769-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 PEOPLES PLZ",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197024727",
            "telephone_number": "302-834-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PATRICIA",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "DE",
            "license": "G1-0001135",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS029356L",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "DI 01930700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001084108",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.