Eric Smith, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

13513 Issued in MI

Practice address

18935 Grand River
Detroit, MI 48223-0000

Phone

(313) 835-8280

Fax

(313) 835-2879

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Park Dental Service, P.C.

  • Dental Clinic/Center
  • Detroit, MI
  • NPI 1225584758
  NPD (past) Authorized official

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1922104413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18935 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482232273",
            "telephone_number": "313-835-8280",
            "fax_number": "313-835-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18935 GRAND RIVER",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482230000",
            "telephone_number": "313-835-8280",
            "fax_number": "313-835-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "13513",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24302",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "1958213670",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eddie James Smith Jr., LPN
• Edith Rena Smith, CERTIFIED PEER SUPPO
• Elizabeth Smith, CRNA
• Elvita Smith
• Eric Smith
• Eric S. Smith, PH.D
• Esther Smith
• Eugene Harold Smith, R.PH.
• Eugenia Smith, NURSE PRACTITIONER
• Evelyn Smith

• Dentist in Detroit, MI
• Providers in Detroit, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.