Provider Demographics
NPI:1508011099
Name:JAMES D. SMITH DDS, L.L.C.
Entity Type:Organization
Organization Name:JAMES D. SMITH DDS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, LLC
Authorized Official - Phone:816-254-6557
Mailing Address - Street 1:104 S. STERLING
Mailing Address - Street 2:
Mailing Address - City:SUGAR CREEK
Mailing Address - State:MO
Mailing Address - Zip Code:64054
Mailing Address - Country:US
Mailing Address - Phone:816-254-6557
Mailing Address - Fax:816-254-6550
Practice Address - Street 1:104 S. STERLING
Practice Address - Street 2:
Practice Address - City:SUGAR CREEK
Practice Address - State:MO
Practice Address - Zip Code:64054
Practice Address - Country:US
Practice Address - Phone:816-254-6557
Practice Address - Fax:816-254-6550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO127711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty