DR. BRIAN ROY SMITH (NPI# 1639191182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639191182 |
| Entity Type | Individual |
| Full Name | DR. BRIAN ROY SMITH |
| Credential | DDS |
| Practice Address |
2125 E Bert Kouns Industrial Loop Shreveport LA 71105-5314 |
| Practice Telephone | 3187975812 |
| Practice Fax Number | 3187970390 |
| Mailing Telephone | 3187975812 |
| Mailing Fax Number | 3187970390 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
4752 | LA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1847526 | 05 | |
| TX | T8B090451 | 05 | |
| LA | BLUE CROSS/BLUE SHIELD | C9163 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235665498 | Brian Smith | Prosthetist | 370 Tampa Ave, Pittsburgh, PA 15228-2419 | 2017-05-10 |
| 1952834194 | Brian Smith | Peer Specialist | 769 Hawthorne Ave Ne, Salem, OR 97301-4623 | 2017-04-05 |
| 1649679937 | Brian Douglas Smith | Physical Therapist | 13934 Gold Circle, Omaha, NE 68144 | 2014-08-22 |
| 1003224957 | Brian Smith | Specialist/Technologist | 11400 Concordia University Dr, Austin, TX 78726-1887 | 2014-07-23 |
| 1255768172 | Brian Smith | Orthotist | 209 Milford St, Suite C, Salisbury, MD 21804-7099 | 2013-10-09 |
| 1124327812 | Brian Smith | Physical Therapist | 165 E Intendencia St, Pensacola, FL 32502-5805 | 2011-03-21 |
| 1588998777 | Brian O. Smith | Counselor | 563 E 52nd St, Brooklyn, NY 11203-5311 | 2009-09-22 |
| 1972749091 | Brian Alan Smith | Chiropractor | 3692 Bancroft St, San Diego, CA 92104-4309 | 2008-12-18 |
| 1780842047 | Brian W Smith | Marriage & Family Therapist | 7938 Le Berthon St, Sunland, CA 91040-2220 | 2008-05-22 |
| 1427244805 | Brian Joseph Smith | Physical Therapist | 1704 Sideline Rd, Quakertown, PA 18951-3331 | 2007-09-19 |
| Street Address |
2125 E BERT KOUNS INDUSTRIAL LOOP |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-5314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588078224 | Ricardo Lugo | Dentist | 1501 Kings Hwy Rm 530, Shreveport, LA 71103-4228 | 2014-06-19 |
| 1548427693 | David Kyle Clark | Dentist | 2120 Bert Kouns Loop Ste D, Shreveport, LA 71118-3351 | 2008-05-16 |
| 1801931209 | Walter Joseph James | Dentist | 915 Shreveport Barksdale Hwy, Shreveport, LA 71105-2205 | 2007-02-21 |
| 1194731836 | James William Sikes Jr. | Dentist | 6912 Fern Loop Ste A, Shreveport, LA 71105-4176 | 2006-08-01 |
| 1750347498 | Jason Harold Lustig | Dentist | 7600 Fern Ave, Building 1400, Shreveport, LA 71105-5659 | 2006-04-21 |
| 1285806810 | Wendell Wayne Neeley II | Dentist | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2008-03-24 |
| 1104095520 | Celso Fernando Palmieri | Dentist | 1501 Kings Hwy, Department of Oral Surgery, Shreveport, LA 71103-4228 | 2008-02-29 |
| 1003092545 | Arklatex Oral & Maxillofacial Surgery A Partnership of Professional De | Dentist | 7600 Fern Ave, Building 1400, Shreveport, LA 71105-5659 | 2008-01-15 |
| 1326188145 | William Brantley Goyne | Dentist | 2001 E 70th St, Suite 606, Shreveport, LA 71105-5328 | 2007-02-08 |
| 1821016957 | Dongsoo David Kim | Dentist | 1501 Kings Hwy, Department of Oral Surgery, Shreveport, LA 71103-4228 | 2006-07-17 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
Please comment or provide details below to improve the information on DR. BRIAN ROY SMITH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.