Shaun Locksley Smith, DDS PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN23095 Issued in FL

Practice address

8223 W Atlantic Blvd
Coral Springs, FL 33071

Phone

(954) 368-0105

Fax

(954) 526-1747

NPI assigned

Apr 7, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Evenly Southeast, PLLC

  • Dental Clinic/Center
  • Coral Springs, FL
  • NPI 1730897240
  NPD Authorized official

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1932499217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8223 W ATLANTIC BLVD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "33071",
            "telephone_number": "954-368-0105",
            "fax_number": "954-526-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8223 W ATLANTIC BLVD",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "33071",
            "telephone_number": "954-368-0105",
            "fax_number": "954-526-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHAUN",
        "middle_name": "LOCKSLEY",
        "name_prefix": "Dr.",
        "credential": "DDS PLLC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-07",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "14770",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN1000968",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401413014",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN23095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiara Smith
• Marcus Smith, AP, L.AC, MSOM
• Narragansett Smith, LMT
• Raylan Dale Smith, CST/CFA
• Shamonia Smith
• Stephanie Smith, PH.D.
• Suan Shantae Smith
• Tanisha Smith
• Tiffany Smith, RD/RDN
• Andrea Sophia Smola

• Orthodontics and Dentofacial Orthopedics Dentistry in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.