Provider Demographics
NPI:1659418374
Name:SMITH, BRADY KENT (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRADY
Middle Name:KENT
Last Name:SMITH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 GAYLORD PKWY STE 1190
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9418
Mailing Address - Country:US
Mailing Address - Phone:844-409-4657
Mailing Address - Fax:214-614-4277
Practice Address - Street 1:4301 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6416
Practice Address - Country:US
Practice Address - Phone:972-255-3712
Practice Address - Fax:972-255-5693
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX146951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice