Daniel Smith

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6769-15 Issued in WI

Practice address

3520 W Oklahoma Ave
Milwaukee, WI 53215-4175

Phone

(414) 645-0365

NPI assigned

Jul 27, 2011

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

Enrolled in WI

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Paul D Smith D.D.S., S.C. Dba Jackson Park Family Dental

  • Dentist
  • Milwaukee, WI
  • NPI 1558023622
  NPD (past) Authorized official

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

{
    "created_epoch": "1311724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311724800000",
    "number": "1972881787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154175",
            "telephone_number": "414-645-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154175",
            "telephone_number": "414-645-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-27",
        "last_updated": "2011-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6769-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cosette Elizabeth Heigaard Smith, LMFT, MS
• Craig R Smith, RN, CRNA
• Curtis W Smith, LMFT-IT
• Damaris Mae Smith, RN
• Dana Smith
• Daryl Smith, CNA, CBRF CERTIFIED
• David S Smith
• Debra Ann Smith
• Derek Smith, LCSW
• Desilynn G Smith, MS, LPC, ICS, CSAC

• General Practice Dentistry in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.