MEDICARE: DR. RICHARD MADSEN SMITH DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	9826	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G60178-1	OTHER	TX	CHIP PROVIDER NUMBER

General Provider Information

NPI Number	:	1023234606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD MADSEN SMITH DDS

Provider Business Mailing Address
First Line	:	3611 S GEORGIA ST
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79109-4847
Country	:	US
Telephone Number	:	806-353-4361
Fax Number	:	806-353-4767

Provider Business Practice Location Address
First Line	:	3611 S GEORGIA ST
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79109-4847
Country	:	US
Telephone Number	:	806-353-4361
Fax Number	:	806-353-4767

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	01/25/2026

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