Crystal Jo Smith, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2675 Issued in NM

Practice address

BLDG 38801 Academic Dr
Suite B & C
Ft Gordon, GA 30905-5660

Phone

(706) 787-6927

NPI assigned

Dec 22, 2005

Sex

Female

Sole proprietor

Yes

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1831175769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 WOODBERRY DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094456",
            "telephone_number": "816-506-8432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 38801 ACADEMIC DR",
            "address_2": "SUITE B & C",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055660",
            "telephone_number": "706-787-6927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CRYSTAL",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "2675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan M Slattery, D.O
• Allyson C Sleeman, PHARMD
• Regina L Slutzky, LCSW
• Kaylyn Kevyna Small, PTA
• Angela Jo Smith, RDH
• William Andrew Socrates, PA-C
• Jae Yun Song, DMD
• Margaret R. Souers, LCSW
• Joshua Thomas Sparks, D.M.D.
• Vicky Lynn Spite

• General Practice Dentistry in Ft Gordon, GA
• Providers in Ft Gordon, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.