MEDICARE: AILEEN E SMITH DMD

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	20094	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841291424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AILEEN E SMITH DMD

Provider Business Mailing Address
First Line	:	PO BOX 781814
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32878-1814
Country	:	US
Telephone Number	:	787-646-0944
Fax Number	:

Provider Business Practice Location Address
First Line	:	4441 HOFFNER AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-2331
Country	:	US
Telephone Number	:	407-537-0617
Fax Number	:

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	12/03/2018

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