Provider Demographics
NPI:1811022601
Name:SMITH, JAMES E (DMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:SMITH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 NORTHWAY CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4916
Mailing Address - Country:US
Mailing Address - Phone:919-847-6000
Mailing Address - Fax:919-847-3159
Practice Address - Street 1:120 NORTHWAY CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4916
Practice Address - Country:US
Practice Address - Phone:919-847-6000
Practice Address - Fax:919-847-3159
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC64071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice