Healthcare Provider Details

I. General information

NPI: 1164331666
Provider Name (Legal Business Name): CHAD SMART DDS AND VINCENT O KOKICH JR DMD MSD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3519 56TH ST STE 120
GIG HARBOR WA
98335-8593
US

IV. Provider business mailing address

3519 56TH ST STE 120
GIG HARBOR WA
98335-8593
US

V. Phone/Fax

Practice location:
  • Phone: 253-851-6789
  • Fax: 253-851-9558
Mailing address:
  • Phone: 253-851-6789
  • Fax: 253-851-9558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ROSEANNE ANTHONY
Title or Position: FINANCE/HR MANAGER
Credential:
Phone: 253-752-3949