Branko Smida, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

52933 Issued in CA

Practice address

1690 Tiburon Blvd
Tiburon, CA 94920-2543

Phone

(415) 328-5129

Fax

(415) 789-0885

NPI assigned

Jul 22, 2009

Last updated

Jul 22, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1730319963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 TIBURON BLVD",
            "city": "TIBURON",
            "state": "CA",
            "postal_code": "949202543",
            "telephone_number": "415-328-5129",
            "fax_number": "415-789-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 TIBURON BLVD",
            "city": "TIBURON",
            "state": "CA",
            "postal_code": "949202543",
            "telephone_number": "415-328-5129",
            "fax_number": "415-789-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIDA",
        "first_name": "BRANKO",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "52933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Rourke- Schlueter, PT
• Stacey Elizabeth Schoenstadt Kempler, LMFT, ATR-BC
• Homam Sebti, DDS
• Liza Siegel
• Kirsten Siewert, LMFT
• Southern Marin Emergency Medical Paramedic System
• Lauren Stephany, OT
• Susan Howard Stephens, PT MED
• Stan Taubman, PHD
• Tiburon Physical Therapy Center Inc

• Dentist in Tiburon, CA
• Providers in Tiburon, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.