Active NPI
Justin Alan Smith, DDS
- General Practice Dentistry
- El Dorado, AR
National Provider Identifier
1992804140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- AR3355
- Practice address
- 701 W Oak St
El Dorado, AR 71730-5487 - Phone
- (870) 862-7708
- Fax
- (870) 862-8806
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | AR3355 | AR | Primary |
Addresses
Primary practice location
701 W Oak St
El Dorado, AR 71730-5487
Mailing address
701 W Oak St
El Dorado, AR 71730-5487
Phone (870) 862-7708
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 1, 2016 through Jun 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AR3355 | AR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308873600000",
"number": "1992804140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 W OAK ST",
"city": "EL DORADO",
"state": "AR",
"postal_code": "717305487",
"telephone_number": "870-862-7708",
"fax_number": "870-862-8806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 W OAK ST",
"city": "EL DORADO",
"state": "AR",
"postal_code": "717305487",
"telephone_number": "870-862-7708",
"fax_number": "870-862-8806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JUSTIN",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2011-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "AR3355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Dorado, AR
- Amy Samantha Smith
- Becca Smith
- George William Smith, M.D.
- Jared Smith
- Julie Elaine Smith, M.S. OTR/L
- Snell Prosthetic & Orthotic Laboratory
- South Ar Developmental Center for Children and Families
- South Ar Surgical Clinic of El Dorado, Inc
- South Arkansas Anesthesia Associates, LLC
- South Arkansas Caring Pregnancy Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.