Healthcare Provider Details

I. General information

NPI: 1417244054
Provider Name (Legal Business Name): B KENT SMITH DDS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2011
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6031 CONNECTION DR STE 100
IRVING TX
75039-2604
US

IV. Provider business mailing address

290 E JOHN CARPENTER FWY #2700
IRVING TX
75062-2730
US

V. Phone/Fax

Practice location:
  • Phone: 844-409-4657
  • Fax: 972-255-5693
Mailing address:
  • Phone: 972-255-3712
  • Fax: 972-255-5693

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: DR. BRADY KENT SMITH
Title or Position: OWNER
Credential: D.D.S.
Phone: 972-255-3712