Individual provider Active NPI

Deena Holliman Smith, D.M.D

  • General Practice Dentistry
  • Forsyth, GA
National Provider Identifier
1992926091
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN010549 Issued in GA
Practice address
205 Medical CT
Forsyth, GA 31029-1662
Phone
(478) 994-1171
Fax
(478) 994-2975
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN010549 GA Primary

Addresses

Primary practice location

205 Medical CT
Forsyth, GA 31029-1662

Mailing address

205 Medical CT
Forsyth, GA 31029-1662
Phone (478) 994-1171

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN010549GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Deena Holliman Smith, DMD, PC General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992926091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 MEDICAL CT",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310291662",
            "telephone_number": "478-994-1171",
            "fax_number": "478-994-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MEDICAL CT",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310291662",
            "telephone_number": "478-994-1171",
            "fax_number": "478-994-2975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DEENA",
        "middle_name": "HOLLIMAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN010549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forsyth, GA

Sources for this page

Verify at the official NPI Registry.