Gerald A Smith

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN010244 Issued in GA

Practice address

3755 Sixes Rd
Suite 200
Canton, GA 30114-7842

Phone

(770) 704-7157

NPI assigned

May 5, 2008

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

Other names 1

• Dr. Jerry A Smith Other name

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": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1962678425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 SIXES RD",
            "address_2": "SUITE 200",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301147842",
            "telephone_number": "770-704-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 SIXES RD",
            "address_2": "SUITE 200",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301147842",
            "telephone_number": "770-704-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GERALD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-05",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN010244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERRY",
            "last_name": "SMITH",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Benjamin Andrew Smith, DMD
• Caitlyn Hope Smith, NP
• Daniel Jay Smith
• Darlene Loretta Smith
• Emma Alexandra Smith
• Heather Dayle Smith, PHARM.D.
• Jessica Smith, RPH
• Jody Lee Smith, PHARMD
• Julia Smith
• Kindred Elizabeth Smith, LPC

• Orthodontics and Dentofacial Orthopedics Dentistry in Canton, GA
• Providers in Canton, GA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; 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.