Provider Demographics
NPI:1033163837
Name:SMITH, DANIEL ERIN (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ERIN
Last Name:SMITH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:303-493-7000
Mailing Address - Fax:
Practice Address - Street 1:30952 S INDIAN HILLS RD
Practice Address - Street 2:
Practice Address - City:OSAGE CITY
Practice Address - State:KS
Practice Address - Zip Code:66523-9089
Practice Address - Country:US
Practice Address - Phone:785-979-1570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2824152W00000X
CO2965152W00000X, 152WP0200X
KS14433152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1510319Medicaid
CO2965OtherOPTOMETRY LICENSE
TNMS0128555OtherDEA
TN2824OtherTN
TN2824OtherTN
U53706Medicare UPIN
TN3590095Medicare Oscar/Certification