Lorena Chacon-Smith, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31209 Issued in TX

Practice address

905 N Gulf Blvd
Freeport, TX 77541-3907

Phone

(281) 824-1490

Fax

(281) 220-6407

NPI assigned

Jul 30, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Locations

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.

• Stephen F. Austin Community Health Center, Inc.

  dba Adoue Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Alvin, TX
  • NPI 1578730818
  Medicare reassignment NPD
• Stephen F Austin Community Health Center,Inc

  dba Bacliff Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Bacliff, TX
  • NPI 1962986562
  NPD

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1982089074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2491 WOODBURY ST",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775844801",
            "telephone_number": "719-660-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 N GULF BLVD",
            "city": "FREEPORT",
            "state": "TX",
            "postal_code": "775413907",
            "telephone_number": "281-824-1490",
            "fax_number": "281-220-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACON-SMITH",
        "first_name": "LORENA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "364193801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ay Dental PA
• Bcba4Hope, LLC
• Bi County Emergency Medical Service Inc (Bi County EMS)
• Brazoria County EMS Inc (Brazoria County EMS)
• Brazosport Community Medical Clinic
• Subair Christmas Spencer
• City of Freeport (Freeport Fire/EMS)
• Melissa Colvin, NP-C
• Jeffrey L Copeland, D.D.S.
• Katie Jo Cotta, FNP

• General Practice Dentistry in Freeport, TX
• Providers in Freeport, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.