Active NPI
Latonia Shante Smith, DDS
- General Practice Dentistry
- Grand Prairie, TX
National Provider Identifier
1881817740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 23117
- Practice address
- 2701 Osler Dr
Suite 10
Grand Prairie, TX 75051-1064 - Phone
- (979) 595-7276
- Fax
- (972) 641-5448
- NPI assigned
- Apr 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 23117 | TX | Primary |
Addresses
Primary practice location
2701 Osler Dr
Suite 10
Grand Prairie, TX 75051-1064
Mailing address
2701 Osler Dr
Suite 10
Grand Prairie, TX 75051-1064
Phone (979) 595-7276
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 154467801 | Medicaid | TX | |
| 154467803 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23117 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Dental Health & Wellness Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Grand Prairie, TX
- NPI 1548509508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329868800000",
"number": "1881817740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 OSLER DR",
"address_2": "SUITE 10",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750511064",
"telephone_number": "979-595-7276",
"fax_number": "972-641-5448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 OSLER DR",
"address_2": "SUITE 10",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750511064",
"telephone_number": "979-595-7276",
"fax_number": "972-641-5448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "LATONIA",
"middle_name": "SHANTE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-10",
"last_updated": "2012-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "23117",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "154467801",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "154467803",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Prairie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.