Evan Keith Smith, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10447 Issued in NC

Practice address

135 Perrin PL Ste 100
Charlotte, NC 28207-2356

Phone

(704) 332-1211

NPI assigned

Jul 19, 2011

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

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.

Opted out of Medicare

Yes, effective Jul 20, 2017 through Jul 20, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1720376288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 PERRIN PL STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072356",
            "telephone_number": "704-332-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PERRIN PL STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072356",
            "telephone_number": "704-332-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EVAN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Canty Smith, CRNA
• Erica E Smith
• Erin Smith, M.D.
• Erin Dacey Smith, OTR/L
• Erin Mancuso Smith, M.D.
• Frances Jacobs Smith, MSW, LCSW
• Gabriel Smith, M.ED, NCC
• Garrett Russell Smith, LAT, ATC
• Gary Lamont Smith
• Harmony Smith, LCMHCA

• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.