Charles V Smith, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5001157 Issued in WI

Practice address

217 E. 4TH St
Blair, WI 54616-0816

Phone

(608) 989-2771

Fax

(608) 989-9626

NPI assigned

Jul 25, 2006

Last updated

May 29, 2013By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• CV Smith SC

  • General Practice Dentistry
  • Blair, WI
  • NPI 1730215393
  NPD (past) Authorized official

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1740203553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 816",
            "address_2": "217 E. 4TH ST",
            "city": "BLAIR",
            "state": "WI",
            "postal_code": "546160816",
            "telephone_number": "608-989-2771",
            "fax_number": "608-989-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 E. 4TH ST",
            "city": "BLAIR",
            "state": "WI",
            "postal_code": "546160816",
            "telephone_number": "608-989-2771",
            "fax_number": "608-989-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLES",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33592400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawna Rae Pientok, RN
• Teresa Marie Radcliffe, L.M.T
• Catherine W. Robertson, PT
• Madeleine Robinson
• School District of Blair Taylor
• Rachel Ann Solberg, PHARMD
• Tri-County Memorial Hospital, Inc.
• Wildcat Legacy School LLC

• General Practice Dentistry in Blair, WI
• Providers in Blair, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.