Dr Dennis Rayvon Smith, DDS is a
Dentist based in Gordon, Georgia. Dr Dennis Rayvon Smith is licensed to practice in Georgia (license number 10175) and his current practice location is
106 College Street, Gordon, Georgia. He can be reached at his office (for appointments etc.) via phone at
(478) 628-2142.
NPI number for Dr Dennis Rayvon Smith is 1124173356 and his current mailing address is Po Box 326, 106 College Street, Gordon, Georgia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1124173356.
Healthcare Provider's Profile
| Full Name | Dr Dennis Rayvon Smith |
|---|
| Gender | Male |
|---|
| Speciality | Dentist |
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| Location | 106 College Street, Gordon, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1124173356
- Provider Enumeration Date: 01/25/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Dennis Rayvon Smith such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124173356 | NPI | - | NPPES |
| 100138 | Other | GA | AVESIS |
| 000018378C | Medicaid | GA | |
| 108516 | Other | GA | DORAL - WELLCARE |
| 582423363 | Other | GA | TAX ID # |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 10175 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Dennis Rayvon Smith is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Dennis Rayvon Smith, DDS
Po Box 326, 106 College Street,
Gordon, GA 31031-0326
Ph: (478) 628-2142 | Dr Dennis Rayvon Smith, DDS
106 College Street,
Gordon, GA 31031-0326
Ph: (478) 628-2142 |
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