Healthcare Provider Details

I. General information

NPI: 1124947999
Provider Name (Legal Business Name): ZACHARY THOMAS SMITH DMD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2533 LARKIN RD STE 102
LEXINGTON KY
40503-3278
US

IV. Provider business mailing address

2533 LARKIN RD STE 102
LEXINGTON KY
40503-3278
US

V. Phone/Fax

Practice location:
  • Phone: 859-277-6113
  • Fax:
Mailing address:
  • Phone: 859-277-6113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number11006
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: