Healthcare Provider Details

I. General information

NPI: 1790101020
Provider Name (Legal Business Name): B KENT SMITH DDS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2014
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 GAYLORD PKWY STE 1190
FRISCO TX
75034-9416
US

IV. Provider business mailing address

3800 GAYLORD PKWY STE 1190
FRISCO TX
75034-9418
US

V. Phone/Fax

Practice location:
  • Phone: 844-409-4657
  • Fax:
Mailing address:
  • Phone: 844-409-4657
  • Fax: 214-614-4277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number14695
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: B KENT SMITH
Title or Position: OWNER
Credential: DDS
Phone: 844-409-4657