Active NPI
Terence Jay Smith, DDS
- Periodontics
- Fair Lawn, NJ
National Provider Identifier
1912010679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- D11585
- Practice address
- 19-21 Fair Lawn Ave
Fair Lawn, NJ 07410-2331 - Phone
- (201) 794-0260
- Fax
- (201) 794-7697
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | D11585 | NJ | Primary |
Addresses
Primary practice location
19-21 Fair Lawn Ave
Fair Lawn, NJ 07410-2331
Mailing address
19-21 Fair Lawn Ave
Fair Lawn, NJ 07410-2331
Phone (201) 794-0260
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D11585 | NJ | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408320000000",
"number": "1912010679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19-21 FAIR LAWN AVE",
"city": "FAIR LAWN",
"state": "NJ",
"postal_code": "074102331",
"telephone_number": "201-794-0260",
"fax_number": "201-794-7697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19-21 FAIR LAWN AVE",
"city": "FAIR LAWN",
"state": "NJ",
"postal_code": "074102331",
"telephone_number": "201-794-0260",
"fax_number": "201-794-7697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "TERENCE",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2014-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NJ",
"license": "D11585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fair Lawn, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.