Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1053206672 Individual Practitioner

Dr. Ethan J Smith , DDS

Dentist - General Practice • Waterloo, IA

Professional Overview & Biography Verified Profile Summary

Dr. Ethan Smith, DDS is a registered healthcare professional specializing in Dentist - General Practice in Waterloo, IA. Practice services are available at 4031 BANKERS BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4031 Bankers Blvd

Waterloo, IA 507017900

Telephone 3192329023
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Waterloo, IA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 1.0 Yrs
State Avg: 9.0 Yrs
Regional Practice Density
34 Specialists

Practicing in Waterloo, IA (1303 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-06-22
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IA 10363

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
NPI 1013222330

Doctor of Dental Surgery

Dr. Jeffrey Smith , DDS

Dentist - General Practice

NPI 1114033248

Doctor of Dental Surgery

Laura Kurtz

Dentist - General Practice

NPI 1134535818
Dr. Teryl Edwards , DDS

Dentist - General Practice

NPI 1215043344

Doctor of Dental Surgery

Dr. Emma Richter , DDS

Dentist - General Practice

NPI 1851021596

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 22, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location June 22, 2025

Registered at 4031 BANKERS BLVD, WATERLOO, IA 507017900 (Tel: 3192329023)

📍
Updated Business Mailing Address June 22, 2025

Registered at 4031 BANKERS BLVD, WATERLOO, IA 507017900 (Tel: 3192329023)

👤
Provider Name / Credentials Updated June 22, 2025

Recorded as ETHAN SMITH, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 22, 2025

Dentist (License #10363 in IA)

🟢
Initial NPI Registration & Enumeration June 12, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1053206672
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 12, 2025
Last Update: June 22, 2025
Sole Proprietor: No

Mailing Address

4031 Bankers Blvd

Waterloo, IA 507017900

Phone: 3192329023

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.