Healthcare Provider Details

I. General information

NPI: 1225712508
Provider Name (Legal Business Name): LILY PARKER SMITH DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2817 CHILDRESS DR
ANDERSON CA
96007-3563
US

IV. Provider business mailing address

4211 ACADIA PL
REDDING CA
96001-0263
US

V. Phone/Fax

Practice location:
  • Phone: 530-365-3351
  • Fax:
Mailing address:
  • Phone: 530-440-4778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113707
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: