Individual provider Active NPI

Craig Ardie Smith, DDS PA

  • Dentist
  • Greenbelt, MD
National Provider Identifier
1689777062
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12483 Issued in MD
Practice address
7201 Hanover Parkway Ste a
Greenbelt, MD 20770-2006
Phone
(301) 446-1784
Fax
(301) 446-1787
NPI assigned
Sep 7, 2006
Sex
Male
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12483 MD Primary

Addresses

Primary practice location

7201 Hanover Parkway Ste a
Greenbelt, MD 20770-2006

Mailing address

7201 Hanover Parkway Ste a
Greenbelt, MD 20770-2006
Phone (301) 446-1784

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
12483MDMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689777062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 HANOVER PARKWAY STE A",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207702006",
            "telephone_number": "301-446-1784",
            "fax_number": "301-446-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 HANOVER PARKWAY STE A",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207702006",
            "telephone_number": "301-446-1784",
            "fax_number": "301-446-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CRAIG",
        "middle_name": "ARDIE",
        "name_prefix": "Dr.",
        "credential": "DDS PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "12483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbelt, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.