Provider Demographics
NPI:1104185818
Name:SMITH, NATHIFA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATHIFA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 PARKER HOUSE TERRACE
Mailing Address - Street 2:APT 409
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782
Mailing Address - Country:US
Mailing Address - Phone:850-212-0735
Mailing Address - Fax:
Practice Address - Street 1:4865 HEDGCOXE RD STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2409
Practice Address - Country:US
Practice Address - Phone:972-820-2022
Practice Address - Fax:972-820-2024
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN195631223P0221X
TX308061223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry