Individual provider Active NPI

Robert Terry Smith, D.D.S.

  • General Practice Dentistry
  • Colfax, WA
National Provider Identifier
1912094632
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6070 Issued in WA
Practice address
116 E Spring St
Colfax, WA 99111-1833
Phone
(509) 397-4141
NPI assigned
Oct 5, 2006
Last updated
Jul 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 6070 WA
General Practice Dentistry 1223G0001X 6070 WA Primary

Addresses

Primary practice location

116 E Spring St
Colfax, WA 99111-1833

Mailing address

116 E Spring St
Colfax, WA 99111-1833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20160314002135 WA Order and Referring Only - DentistPractitioner - Dentist 6103122346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6070WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Robert T Smith DDS Durable Medical Equipment & Medical Supplies CurrentSince Jul 1, 1985 Accepting new patients
John L Turner DMD PLLC PastSince Aug 6, 2019 Accepting new patients

Locations

116 E Spring St
Colfax, WA 99111
Phone (509) 397-4141

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1912094632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 E SPRING ST",
            "city": "COLFAX",
            "state": "WA",
            "postal_code": "991111833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E SPRING ST",
            "city": "COLFAX",
            "state": "WA",
            "postal_code": "991111833",
            "telephone_number": "509-397-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROBERT",
        "middle_name": "TERRY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WA",
            "license": "6070",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "6070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colfax, WA

Sources for this page

Verify at the official NPI Registry.