DR. RANDALL G. SMITH (NPI# 1659412724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659412724 |
| Entity Type | Individual |
| Full Name | DR. RANDALL G. SMITH |
| Other Name | RANDY G. SMITH |
| Practice Address |
3365 S Holmes Ave Idaho Falls ID 83404-7981 |
| Practice Telephone | 2085421333 |
| Mailing Telephone | 2085421333 |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-01-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D3257PD | ID | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS OF IDAHO | 6C024 | 01 |
| ID | 804126800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922638634 | Randall Jay Smith | Substance Abuse Rehabilitation Facility | 1321 S Westwood Dr, Zanesville, OH 43701-5650 | 2020-01-22 |
| 1841736477 | Randall Smith | Counselor | 7000 Romaine, 207-208, La, CA 90038 | 2017-01-06 |
| 1184177826 | Randall Smith | Counselor | 2303 Lamy Ln, Monroe, LA 71201 | 2016-07-29 |
| 1972845667 | Randall E. Smith | Marriage & Family Therapist | 9103 Trentham Ln, Louisville, KY 40242-3383 | 2013-03-21 |
| 1104179985 | Randall Bruce Smith | Nurse Practitioner | 2800 Opryland Dr, Nashville, TN 37214-1200 | 2012-10-18 |
| 1891085346 | Randall Ann Smith | Counselor | 160 S 600 E, #300, Salt Lake City, UT 84102-1962 | 2011-04-17 |
| 1093945289 | Randall James Smith | Pharmacist | 64 Congress St, Ink Plaza &the Other Pharmacy, Rumford, ME 04276-2003 | 2009-07-22 |
| 1316192388 | Randall Lamar Smith | Dentist | 4089 Val Tech Rd, Valdosta, GA 31602-0929 | 2008-11-18 |
| 1730246844 | Randall Warren Smith | Chiropractor | 442 Sunnyside Ave., Wheaton, IL 60187-5006 | 2007-01-02 |
| 1558437574 | Randall B. Smith | Dentist | Parker Indian Health Cernter, 12033 Agency Rd., Parker, AZ 85344 | 2006-11-28 |
| Street Address |
3365 S HOLMES AVE |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-7981 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336433689 | Maxfield Anesthesia | Nurse Anesthetist, Certified Registered | 3365 S Holmes Ave, Idaho Falls, ID 83404-7981 | 2011-06-03 |
| 1679747588 | Alligator Pediatric Dentistry,pllc | Dentist | 3365 S Holmes Ave, Idaho Falls, ID 83404-7981 | 2008-04-22 |
| 1851511372 | Mark Marlowe | Dentist | 3365 S Holmes Ave, Idaho Falls, ID 83404-7981 | 2007-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 1942863600 | Muhammad Arslan Khan | Student in an Organized Health Care Education/Training Program | 2860 Channing Way Suite 214, Idaho Falls, ID 83404 | 2019-04-18 |
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1083196380 | Hannah Golden | Occupational Therapist | 1460 Elk Creek, Idaho Falls, ID 83404 | 2018-09-04 |
| 1316423049 | Lindsay Sessions | Speech-Language Pathologist | 2210 Niagara St, Idaho Falls, ID 83404 | 2018-07-16 |
| 1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1235682121 | Mountain Falls Quick Care | Clinic/Center | 1995 E 17th St #1, Idaho Falls, ID 83404 | 2016-07-27 |
| Find all providers in zip 83404 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710186432 | Jordan Higham | Dentist | 929 S Utah Ave, Idaho Falls, ID 83402-3322 | 2007-07-12 |
| 1700447596 | Idaho Falls Pediatric Dentistry, Pllc | Dentist | 3387 Merlin Dr, Idaho Falls, ID 83404-7405 | 2019-06-24 |
| 1376028324 | Clubhouse Pediatric Dentistry of Idaho Falls | Dentist | 3411 Merlin Dr, Idaho Falls, ID 83404-7430 | 2018-09-26 |
| 1831504125 | Kailey Anne Smith Housley | Dentist | 3387 Merlin Dr, Idaho Falls, ID 83404-7405 | 2014-06-25 |
| 1376969360 | Thomas Baker | Dentist | 1900 John Adams Pkwy, Idaho Falls, ID 83401-4366 | 2014-03-14 |
| 1437595881 | Jordan E. Higham Pa | Dentist | 929 S Utah Ave, Idaho Falls, ID 83402-3322 | 2013-05-13 |
| 1679747588 | Alligator Pediatric Dentistry,pllc | Dentist | 3365 S Holmes Ave, Idaho Falls, ID 83404-7981 | 2008-04-22 |
| 1851511372 | Mark Marlowe | Dentist | 3365 S Holmes Ave, Idaho Falls, ID 83404-7981 | 2007-04-26 |
| 1801944913 | John Memmott | Dentist | 2300 E 17th St, Idaho Falls, ID 83404-6504 | 2007-01-08 |
| 1326131319 | Drostan Gregg Baker | Dentist | 1900 John Adams Pkwy, Idaho Falls, ID 83401-4366 | 2006-10-02 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83404 |
Please comment or provide details below to improve the information on DR. RANDALL G. 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.