Individual provider Active NPI

Terry Robert Smith, D.D.S.

  • General Practice Dentistry
  • Guthrie, OK
National Provider Identifier
1780612960
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4431 Issued in OK
Practice address
303 N Division St
Guthrie, OK 73044-3203
Phone
(405) 282-8120
Fax
(405) 282-8122
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4431 OK Primary

Addresses

Primary practice location

303 N Division St
Guthrie, OK 73044-3203

Mailing address

303 N Division St
Guthrie, OK 73044-3203
Phone (405) 282-8120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20150604002180 OK Order and Referring Only - DentistPractitioner - Dentist 4688995467

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4431OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Terry R. Smith,DDS,PC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780612960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N DIVISION ST",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730443203",
            "telephone_number": "405-282-8120",
            "fax_number": "405-282-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N DIVISION ST",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730443203",
            "telephone_number": "405-282-8120",
            "fax_number": "405-282-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TERRY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guthrie, OK

Sources for this page

Verify at the official NPI Registry.