Edgar Lee Smith, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5403 Issued in IA

Practice address

1820 80TH Jstreet
Des Moines, IA 50322-5602

Phone

(515) 276-0830

NPI assigned

Jun 1, 2007

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

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790987790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 80TH ST",
            "city": "WINDSOR HEIGHTS",
            "state": "IA",
            "postal_code": "503225602",
            "telephone_number": "515-276-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 80TH JSTREET",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503225602",
            "telephone_number": "515-276-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EDGAR",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "5403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1039107",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clayton Thomas Smith, DO
• Clinton R. Smith, ARNP
• Courtney Rose Smith, RD, LD
• Deborah Smith, LMFT
• Debra Smith, PA-C
• Edward Charles Smith, RDCS
• Emily Smith, LISW
• Evan Hasani-Obadiah Smith, MD
• Gregory L Smith, MD
• Isabella Smith

• General Practice Dentistry in Des Moines, IA
• Providers in Des Moines, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.