DR. SAMUEL MADISON SMITH JR. (NPI# 1770671109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770671109 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL MADISON SMITH JR. |
| Credential | DMD |
| Practice Address |
1519 East Mccord Centralia IL 62801 |
| Practice Telephone | 6185321879 |
| Practice Fax Number | 6185320479 |
| Mailing Telephone | 6185321879 |
| Mailing Fax Number | 6185320479 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487124376 | Samuel Smith | Occupational Therapist | 174 S Freeport Rd Ste 1a, Freeport, ME 04032-6160 | 2018-12-04 |
| 1922527191 | Samuel Maria Smith | Chiropractor | 1012 Poly Dr, Billings, MT 59102-1832 | 2017-09-19 |
| 1073967949 | Samuel Henry Smith | Student in an Organized Health Care Education/Training Program | Universuty of Tennessee, 920 Madison Avenue Suite 447, Memphis, TN 38163-0001 | 2016-04-18 |
| 1285805846 | Samuel Bardwell Smith | Psychologist | 1279 Linda Mar Shopping Ctr, Suite 112, Pacifica, CA 94044-3347 | 2008-03-21 |
| 1588873624 | Samuel L Smith | Chiropractor | 7743 E Broadway Blvd, Tucson, AZ 85710-3941 | 2007-05-22 |
| 1215076518 | Samuel Goodale Smith | Obstetrics & Gynecology | 307 Noble Faire Dr, Sun City Center, FL 33573-6432 | 2007-02-05 |
| 1841363132 | Samuel M Smith | Anesthesiology | 975 E Third S, Chattanooga, TN 37403-2147 | 2006-11-16 |
| 1013920313 | Samuel G. Smith | Dentist | 1541 S. Times Square, Boise, ID 83709 | 2006-08-15 |
| 1649226309 | Samuel R Smith | Chiropractor | 279 West Main Street, #8, Middletown, PA 17057-1222 | 2006-05-25 |
| 1962018986 | Samuel Smith | Physical Therapist | 272 Highland Drive, Lebanon, VA 24266 | 2020-09-16 |
| Street Address |
1519 EAST MCCORD |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992087282 | Wilson & Wilson, Dds Pllc | Dentist | 1611 Kresky Ave Ste 118, Centralia, WA 98531-8982 | 2011-09-13 |
| 1225270192 | Vanessa L Cole | Dentist | 516 S Locust St, Centralia, IL 62801-4224 | 2009-03-24 |
| 1184747362 | Kianor Shahmohammadi | Dentist | 135 S Sycamore St, Centralia, IL 62801-3525 | 2007-04-10 |
| 1043332745 | Ash & Roberts Dds Pllc | Dentist | 2409 Borst Ave, Centralia, WA 98531 | 2007-04-04 |
| 1396894093 | Abdul L Junidi | Dentist | 1035 E Jonas St, Centralia, IL 62801-3309 | 2007-01-10 |
| 1467421883 | Rohn Falter | Dentist | 1716 S Gold St, Centralia, WA 98531-8951 | 2006-03-16 |
| 1598752263 | James Wilford Tetz | Dentist | 709 Harrison Ave, Centralia, WA 98531-2109 | 2005-09-28 |
| 1033620570 | Smile Dental Centralia LLC | Dentist | 110 W Sneed St, Centralia, MO 65240-1375 | 2017-10-23 |
| 1659796076 | Kids Dental of Centralia, P.C. | Dentist | 1611 Kresky Ave, Centralia, WA 98531-8982 | 2014-02-21 |
| 1720366149 | Scott David Crane | Dentist | 716 W Main St, Centralia, WA 98531-2847 | 2011-08-02 |
| Find all providers in CENTRALIA | ||||
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| 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.