Healthcare Provider Details

I. General information

NPI: 1366136491
Provider Name (Legal Business Name): B KENT SMITH DDS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 E JOHN CARPENTER FWY STE 2700
IRVING TX
75062-2881
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: 214-614-4277
Mailing address:
  • Phone: 844-409-4657
  • Fax: 214-614-4277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

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