Dr. Samuel Madison Smith , DMD
Dentist - General Practice • Centralia, IL
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Samuel Smith has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Samuel Smith, DMD was a registered Dentist - General Practice practicing in Centralia, IL. Throughout an active medical career spanning 17 years, Dr. Smith provided care at the practice location at 1519 EAST MCCORD until profile deactivation on 2023-09-20.
Practice Location & Contact Primary Location
1519 East Mccord
Centralia, IL 62801
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist - General Practice in Centralia, IL
Practicing in Centralia, IL (5581 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 1223G0001X
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on September 20, 2023
NPI status registered as active in NPPES database
Registered at 1519 EAST MCCORD, CENTRALIA, IL 62801 (Tel: 6185321879)
Registered at 1519 EAST MCCORD, CENTRALIA, IL 62801 (Tel: 6185321879)
Recorded as SAMUEL SMITH, DMD
Dentist
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
1519 East Mccord
Centralia, IL 62801
Phone: 6185321879
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