Mark Wallace Smith, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7415 Issued in IN

Practice address

7650 East State Road 252
Edinburgh, IN 46124

Phone

(812) 526-2026

Fax

(812) 526-2844

NPI assigned

Dec 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dr Mark W Smith DDS LLC

  • Dentist
  • Edinburgh, IN
  • NPI 1730595489
  NPD (past) Authorized official

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699830265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7650 EAST STATE ROAD 252",
            "city": "EDINBURGH",
            "state": "IN",
            "postal_code": "46124",
            "telephone_number": "812-526-2026",
            "fax_number": "812-526-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7650 EAST STATE ROAD 252",
            "city": "EDINBURGH",
            "state": "IN",
            "postal_code": "46124",
            "telephone_number": "812-526-2026",
            "fax_number": "812-526-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARK",
        "middle_name": "WALLACE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "7415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Onnalee Oliver
• HB Park
• Ratsany Sananikone, APRN
• Taylor Schaub, DC
• Colby Smith, RN
• Brandi Nicole Strain, N.P.
• Jennah Colleen Tennell, FNP
• The Alzheimer's Home Safety Network
• Town of Edinburg
• Dorine Trimnell, M.S., CCC-SLP

• General Practice Dentistry in Edinburgh, IN
• Providers in Edinburgh, IN by specialty
• General Practice Dentistry in Indiana

• 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.