Martin McKay Smith

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9971453 Issued in ID

Practice address

120 Desert Sage Way
Mountain Home, ID 83647-1038

Phone

(208) 587-3988

NPI assigned

Apr 15, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Glenns Ferry Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mountain Home, ID
  • NPI 1518097047
  NPD (past)

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

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1881480176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 DESERT SAGE WAY",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836471038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 DESERT SAGE WAY",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836471038",
            "telephone_number": "208-587-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARTIN",
        "middle_name": "MCKAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-15",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "9971453",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "9971453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colten Young Sicard
• Jenny Rochelle Simison
• Courtney Sinfield
• Delmar Wallace Smith, P.A.
• Jolee A Smith, BSW
• Spartan Dental Company, LLC
• St Lukes Clinic-Treasure Valley LLC
• St Lukes Regional Medical Center
• St Lukes Regional Medical Center
• St Lukes Regional Medical Center

• General Practice Dentistry in Mountain Home, ID
• Providers in Mountain Home, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.