Lawrence Scott Smith, DDS
Individual provider Active NPI Dentist · Pomeroy, WA
NPI 1861546038 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1861546038
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DE00004987 (WA)
- Practice address
- 813 Columbia St
Pomeroy, WA 99347-0099 - Phone
- (509) 843-3495
- Fax
- (509) 843-3496
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00004987 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pomeroy Dental Center | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE00004987 | WA | Yes |
Addresses
Primary practice location
813 Columbia St
Pomeroy, WA 99347-0099
Mailing address
PO Box 99
Pomeroy, WA 99347-0099
Phone (509) 843-3495
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5536909 | Medicaid | WA |
Other providers in Pomeroy, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.