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JERROLD W. SMITH D.D.S.P.C. NPI 1730351891


NPI Information

NPI: 1730351891
Provider Name: JERROLD W. SMITH D.D.S.P.C.
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
2000 W 95TH ST
CHICAGO, IL
ZIP 60643
Phone: (773) 881-3910
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JERROLD W. SMITH D.D.S.P.C. is a general practice dentist in Chicago, IL. The provider is 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. JERROLD W. SMITH D.D.S.P.C. NPI is 1730351891. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2000 W 95TH ST
CHICAGO, IL
ZIP 60643-116
Phone: (773) 881-3910
Fax: (773) 881-4058

The provider's authorized official is Jerrold W. Smith .
The authorized official title is President and has the following contact phone number (773) 881-3910.

The enumeration date for this NPI number is 3/28/2008 and was last updated on 3/28/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11003789MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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