DR. GARY ALFRED SMITH (NPI# 1063441384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063441384 |
| Entity Type | Individual |
| Full Name | DR. GARY ALFRED SMITH |
| Credential | D.D.S. |
| Practice Address |
2612 W Broadway Council Bluffs IA 51501-3510 |
| Practice Telephone | 7123233615 |
| Practice Fax Number | 7123256155 |
| Mailing Telephone | 7123233615 |
| Mailing Fax Number | 7123256155 |
| Enumeration Date | 2006-06-30 |
| 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 |
6699 | IA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | WELLMARK | 18575 | 01 |
| IA | DELTA DENTAL-IA | 18575 | 01 |
| NE | BLUE CROSS/BLUE SHIELD-NE | 5334 | 01 |
| PA | UNITED CONCORDIA | 039537 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184254393 | Gary Smith | Counselor | 97 Olde English, Romeoville, IL 60446 | 2020-01-16 |
| 1366879702 | Gary Stephen Smith | Dentist | 1391 Emerald Cir, Southlake, TX 76092-3305 | 2013-09-30 |
| 1104127125 | Gary Webster Smith | Dentist | 404 Fifth Ave., Calvert City, KY 42029 | 2010-11-08 |
| 1578887873 | Gary Lamont Smith | Counselor | 1801 N Tryon St Ste 111, Charlotte, NC 28206-2704 | 2010-03-16 |
| 1558505610 | Gary Dean Smith | Chiropractor | 1778 Watson St N, Enumclaw, WA 98022-3447 | 2009-04-20 |
| 1972781466 | Gary Bruce Smith | Counselor | 1218 West Broadway Avenue, Sulphur, OK 73086-4416 | 2008-02-06 |
| 1639369465 | Gary E.m. Smith | Optometrist | 511 E. Kern Ave., Tulare, CA 93274-4210 | 2007-07-27 |
| 1639372162 | Gary R Smith | Chiropractor | 74-967 Hwy 111, Indian Wells Chiropractic Clinic, Indian Wells, CA 92210 | 2007-06-11 |
| 1578614426 | Gary L. Smith | Dentist | 7600 Raytown Road, Suite 102, Raytown, MO 64138-1855 | 2007-01-16 |
| 1316014582 | Gary Steven Smith | Technician/Technologist | 2400 N Croatan Hwy, Kill Devil Hills, NC 27948-9355 | 2006-11-30 |
| Street Address |
2612 W BROADWAY |
| City | COUNCIL BLUFFS |
| State | IA |
| Zip Code | 51501-3510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194349126 | Dustin Otto Svatos | Dentist | 2612 W Broadway, Council Bluffs, IA 51501-3510 | 2020-06-05 |
| 1063715969 | Broadway Family and Cosmetic Dentistry, Partnership | Dentist | 2612 W Broadway, Council Bluffs, IA 51501-3510 | 2010-12-15 |
| 1578729224 | Cary V Jackson | Dentist | 2612 W Broadway, Council Bluffs, IA 51501-3510 | 2008-08-01 |
| 1053442244 | Broadway Family and Cosmetic Dentistry, P.C. | Dentist | 2612 W Broadway, Council Bluffs, IA 51501-3510 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881204691 | Melissa Sue Sperry | Counselor | Melissa Sperry, 4036 Ramelle Dr, Council Bluffs, IA 51501 | 2020-08-06 |
| 1326689076 | Crc Recovery, Inc. | Clinic/Center | 1750 W Broadway, Council Bluffs, IA 51501 | 2019-10-03 |
| 1518451152 | Naomi Kigondu | Registered Nurse | 2323 W Broadway Ste 100, Council Bluffs, IA 51501 | 2018-06-18 |
| 1710400361 | Travis John Alger | Chiropractor | 3424 W Broadway, Council Bluffs, IA 51501 | 2017-07-25 |
| 1124495692 | Jillian Kahl | Speech-Language Pathologist | 1500 N 16th St, Council Bluffs, IA 51501 | 2015-08-31 |
| 1932584323 | Leigh Healey | Dietitian, Registered | 2323 West Broadway, Council Bluffs, IA 51501 | 2015-07-27 |
| 1942558523 | Karen Irene Godin | Registered Nurse | 1702 N 16th Street, Council Bluffs, IA 51501 | 2012-08-29 |
| 1063787505 | Rebecca F Aboe | Dietitian, Registered | 1702 North 16th St., Council Bluffs, IA 51501 | 2012-03-16 |
| 1972883122 | Sara Ann Lott | Occupational Therapist | 1310 N. 17th St., Council Bluffs, IA 51501 | 2011-08-19 |
| 1700042884 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 3271 Marketplace Dr, Council Bluffs, IA 51501 | 2008-07-29 |
| Find all providers in zip 51501 | ||||
| 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 |
|---|---|---|---|---|
| 1487175634 | Johnathon O'brien | Dentist | 320 Mckenzie Ave Ste 101, Council Bluffs, IA 51503-1002 | 2017-06-28 |
| 1982981692 | Michael Gritzuk | Dentist | 3617 Denmark Dr Ste 100, Council Bluffs, IA 51501-7756 | 2011-11-09 |
| 1841574886 | Western Iowa Dental Group, LLC | Dentist | 1509 Avenue G, Council Bluffs, IA 51501-2516 | 2011-10-10 |
| 1639364383 | Tony Douglas Stuntz | Dentist | 179 Bennett Ave, Council Bluffs, IA 51503-5206 | 2007-09-06 |
| 1689886574 | Stop Decay PC | Dentist | 2800 Twin City Plaza, Council Bluffs, IA 51503 | 2007-05-04 |
| 1518040930 | Richard James Ronk Jr. | Dentist | 200 S 29th St, Council Bluffs, IA 51501-3449 | 2006-10-21 |
| 1902914757 | Tooth Emporium Inc | Dentist | 179 Bennett Avenue, Council Bluffs, IA 51503-5206 | 2006-08-29 |
| 1851311781 | Kimberly Steckler | Dentist | 114 1/2 S 6th St, Council Bluffs, IA 51501-4234 | 2006-07-21 |
| 1366417016 | David Lee Jones | Dentist | 1026 Woodbury Ave, Suite 30, Council Bluffs, IA 51503-7915 | 2006-02-17 |
| 1790774024 | Andrea Lynne Cardenzana | Dentist | 427 E Kanesville Blvd, Ste 200, Council Bluffs, IA 51503-4403 | 2005-10-19 |
| Find all providers in COUNCIL BLUFFS | ||||
| City | COUNCIL BLUFFS |
| Zip Code | 51501 |
Please comment or provide details below to improve the information on DR. GARY ALFRED 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.