Nathan Wadsworth Smith, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6408 Issued in AZ

Practice address

2058 S Dobson Rd Ste 12
Mesa, AZ 85202-6455

Phone

(480) 838-3033

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Smith & Engel Dentistry

  • General Practice Dentistry
  • Mesa, AZ
  • NPI 1205913241
  NPD (past) Authorized official
• East Valley Dental Professionals

  • General Practice Dentistry
  • Mesa, AZ
  • NPI 1982059457
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1912075979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 E INDIGO ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852983218",
            "telephone_number": "480-254-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2058 S DOBSON RD STE 12",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026455",
            "telephone_number": "480-838-3033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2919 S Ellsworth Rd",
            "address_2": "Suite #118",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852122164",
            "country_code": "US",
            "telephone_number": "480-219-1384",
            "fax_number": "480-219-1394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NATHAN",
        "middle_name": "WADSWORTH",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "6408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1902610",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa K Smith, M.S.
• Mercedes Smith
• Merlyn Dean Smith, DO
• Michael Smith, PA-C
• Mylena Dashaun Smith
• Quentin Smith, D.C.
• Reneau M Smith, BHT
• Rick Martin Smith
• Ryan Patrick Smith, D.M.D.
• Sandra Smith, CCP

• General Practice Dentistry in Mesa, AZ
• Providers in Mesa, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.