Healthcare Provider Details

I. General information

NPI: 1285568865
Provider Name (Legal Business Name): DAKOTA SMITH PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2651 E DISCOVERY PKWY
BLOOMINGTON IN
47408-9059
US

IV. Provider business mailing address

7208 WHIRLAWAY CT
GREENVILLE IN
47124-9677
US

V. Phone/Fax

Practice location:
  • Phone: 812-353-5252
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835I0206X
TaxonomyInfectious Diseases Pharmacist
License Number26030750A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: