Kyle Smith

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60777210 Issued in WA

Practice address

6020 35TH Ave SW
Seattle, WA 98126-3002

Phone

(206) 461-6966

Fax

(206) 461-6968

NPI assigned

May 1, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1462060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1972958684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 35TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981263002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 35TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981263002",
            "telephone_number": "206-461-6966",
            "fax_number": "206-461-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-01",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60777210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly David Smith
• Kelsee Smith
• Kendra Renee Smith, LMSW
• Kenneth Andrew Smith
• Kevin L Smith, M.D.
• Lacey Jacqueline Smith, DACM, L.AC., EAMP
• Ladonna Michelle Smith
• Latrecia Smith, CPC
• Lawrence Wesley Smith, PH.D.
• Leah Mae Smith, LMFTA

• General Practice Dentistry in Seattle, WA
• Providers in Seattle, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; 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.