Keith Allan Smiley, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901022316 Issued in MI

Practice address

USA Dentac Fort Cavazos
36000 Shoemaker Lane, Suite 1051
Fort Cavazos, TX 76544

Phone

(616) 826-1529

NPI assigned

Aug 16, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1922524529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "USA DENTAC FORT CAVAZOS",
            "address_2": "36000 SHOEMAKER LANE, SUITE 1051",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "76544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USA DENTAC FORT CAVAZOS",
            "address_2": "36000 SHOEMAKER LANE, SUITE 1051",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "616-826-1529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMILEY",
        "first_name": "KEITH",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-16",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer E. Shepherd, RNC CPNP IBCLC
• Jillian Laverne Shute, DDS
• Wesley Shute, DDS, MS, FACP
• Lisa M. Silva, PSY.D.
• Rory Smith Skinner, PT
• Richard Allen Sonnier, NP
• James Christopher Spradling, CRNA
• Jonathan Srichandra, M.D.
• Jared Matthew Staten, MD
• Carter Steele, DPT, OCS, CSCS

• General Practice Dentistry in Fort Cavazos, TX
• Providers in Fort Cavazos, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.