Active NPI
Thomas Iverson Smith, D.M.D.
- General Practice Dentistry
- Brunswick, GA
National Provider Identifier
1962441535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11022
- Practice address
- 23 Professional Dr
Brunswick, GA 31520-3773 - Phone
- (912) 265-7273
- Fax
- (912) 261-2792
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11022 | GA | Primary |
Addresses
Primary practice location
23 Professional Dr
Brunswick, GA 31520-3773
Mailing address
23 Professional Dr
Brunswick, GA 31520-3773
Phone (912) 265-7273
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 681685 | Other | GA | UNITED CONCORDIA PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11022 | GA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1962441535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 PROFESSIONAL DR",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315203773",
"telephone_number": "912-265-7273",
"fax_number": "912-261-2792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 PROFESSIONAL DR",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315203773",
"telephone_number": "912-265-7273",
"fax_number": "912-261-2792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "THOMAS",
"middle_name": "IVERSON",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "11022",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA PROVIDER",
"identifier": "681685",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brunswick, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.