Samuel Irby Smith DDS PA

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SAMUEL IRBY SMITH DDS PA

Practice address

1001 S Croatan Hwy
Kill Devil Hills, NC 27948-8706

Phone

(252) 499-0700

Fax

(252) 499-0706

NPI assigned

Aug 8, 2007

Last updated

Jul 17, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

SAMUEL IRBY SMITH DDS PAAs reported in NPPES

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

Authorized official

Name

Dr. Samuel Irby Smith, DDSNPI 1164859567

Title

President

Phone

(252) 449-0700

Specialties & licenses 1

Addresses

Other identifiers 2

Part of

Samuel I Smith DDS

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samuel Irby Smith I, DDS, PA

  • Dentist
  • Kill Devil Hills, NC
  • NPI 1164859567
  NPD (past) Authorized official

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1932390481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S CROATAN HWY",
            "address_2": "PO BOX 7429",
            "city": "KILL DEVIL HILLS",
            "state": "NC",
            "postal_code": "279488706",
            "telephone_number": "252-499-0700",
            "fax_number": "252-449-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S CROATAN HWY",
            "city": "KILL DEVIL HILLS",
            "state": "NC",
            "postal_code": "279488706",
            "telephone_number": "252-499-0700",
            "fax_number": "252-499-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL IRBY SMITH DDS PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAMUEL IRBY SMITH DDS PA",
        "enumeration_date": "2007-08-08",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "IRBY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-449-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910814",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8997948",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Carolina CVS Pharmacy LLC (CVS Pharmacy #17838)
• North Carolina CVS Pharmacy LLC (CVS Pharmacy #07361)
• Obx Developmental Therapy, LLC
• Austin Pascoe, RBT
• Michaela Anne Raach, OTR/L
• Brooke Scarborough, BT
• Rikki Rose Schuster, PA
• Sean L. Chapman, D.M.D., P.L.L.C. (First Flight Dental)
• Harvey Hatcher Shiflet V, DMD
• Gary Steven Smith, OPTICIAN

• Dentist in Kill Devil Hills, NC
• Providers in Kill Devil Hills, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.