Ryan Connor Smith, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12012176A Issued in IN

Practice address

Desmond Doss Dental Clinic
BLDG 674 (Letter O) Brannon Road
Schofield Barracks, HI 96857

Phone

(808) 433-6825

NPI assigned

Jul 14, 2014

Last updated

Sep 12, 2023By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1790192524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DESMOND DOSS DENTAL CLINIC",
            "address_2": "BLDG 674 (LETTER O) BRANNON ROAD",
            "city": "SCHOFIELD BARRACKS",
            "state": "HI",
            "postal_code": "96857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DESMOND DOSS DENTAL CLINIC",
            "address_2": "BLDG 674 (LETTER O) BRANNON ROAD",
            "city": "SCHOFIELD BARRACKS",
            "state": "HI",
            "postal_code": "96857",
            "telephone_number": "808-433-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RYAN",
        "middle_name": "CONNOR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012176A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Savage, OTR/L
• Schofield Vision Center, Inc.
• Shawn J Scott, P.T.
• Jessica E. Simmonds, PH.D.
• Priscilla Fuentes Smith, LCSW
• Stacey Tillman Suttles, PA-C
• Sandra Jamilla Tajon, RDH
• Mildred Tang
• Ryan Tatsumoto, PHARM.D.
• The Janz Corporation (Janz Medical Supply)

• Dentist in Schofield Barracks, HI
• Providers in Schofield Barracks, HI by specialty
• Dentist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.