Reed Kim Smith, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D1967 Issued in ID

Practice address

115 E Chapel Road
Pocatello, ID 83201

Phone

(208) 237-6848

Fax

(208) 237-6811

NPI assigned

Oct 24, 2006

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

Other identifiers 1

Other names 1

• R Kim Smith Other name

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 and National Provider Directory roles.

• Four Season Dental PC

  • General Practice Dentistry
  • Pocatello, ID
  • NPI 1215102439
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760566384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E CHAPEL ROAD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-237-6848",
            "fax_number": "208-237-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E CHAPEL ROAD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-237-6848",
            "fax_number": "208-237-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "REED",
        "middle_name": "KIM",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D1967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "6K208",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R",
            "last_name": "SMITH",
            "middle_name": "KIM",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Marielle Smith
• Marilla Michelle Smith
• Maya Smith
• McKay Smith, DO
• Paula Smith, LMSW
• Sarah Smith
• Sariah Jean Smith, DO
• Shannon Marie Smith, MS, CCC-SLP
• Tami Smith, CADC
• Tonya Jean Smith

• General Practice Dentistry in Pocatello, ID
• Providers in Pocatello, ID by specialty
• General Practice Dentistry in Idaho

• 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.