Individual provider Active NPI

Lauren Smith-Nichols, DDS

  • Dentist
  • Clarksville, AR
National Provider Identifier
1811336704
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3934 Issued in AR
Practice address
1101 E Poplar St
Clarksville, AR 72830-4420
Phone
(479) 754-3357
Fax
(479) 754-0167
NPI assigned
Jun 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3934 AR Primary

Addresses

Primary practice location

1101 E Poplar St
Clarksville, AR 72830-4420

Mailing address

1101 E Poplar St
Clarksville, AR 72830-4420
Phone (479) 754-3357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20170123000930 AR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5890077119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1811336704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 E POPLAR ST",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728304420",
            "telephone_number": "479-754-3357",
            "fax_number": "479-754-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E POPLAR ST",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728304420",
            "telephone_number": "479-754-3357",
            "fax_number": "479-754-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-NICHOLS",
        "first_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, AR

Sources for this page

Verify at the official NPI Registry.