Randall L Smith, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31390 Issued in CA

Practice address

1311 S Euclid St
Anaheim, CA 92802-2020

Phone

(714) 774-3690

Fax

(815) 377-3605

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective Dec 18, 2014 through Dec 18, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952336661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 S EUCLID ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928022020",
            "telephone_number": "714-774-3690",
            "fax_number": "815-377-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 S EUCLID ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928022020",
            "telephone_number": "714-774-3690",
            "fax_number": "815-377-3605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RANDALL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mya Claire Smith
• Natasha Smith
• Neal Irvin Smith, B.A.
• Nicholas A Smith I
• Nicole Smith, PA-C
• Sandra W Smith, PHYSICAL THERAPIST
• Sarah Mae Smith, PHD
• Sarah Nicole Smith
• Sarah W Smith
• Steele Clarke Smith, MD

• General Practice Dentistry in Anaheim, CA
• Providers in Anaheim, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.