Dean T Smith, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301028094 Issued in MI

Practice address

391 Shore Haven Dr SE
Grand Rapids, MI 49546-2257

Phone

(616) 479-8936

NPI assigned

May 31, 2005

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1811990252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 SHORE HAVEN DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462257",
            "telephone_number": "616-479-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 SHORE HAVEN DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462257",
            "telephone_number": "616-479-8936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DEAN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301028094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4471960",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Lyn Smith
• Dana Smith
• David Smith Jr.
• David Smith, D.P.M.
• David Ross Smith, RPH
• Douglas Bruce Smith, DO
• Elizabeth Anne Smith, N.P.
• Emma Lynne Smith
• Eric Claude Smith Jr.
• Eric Michael Smith, FNP

• Surgery Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; 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.