Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1255892394 Individual Practitioner Male Practitioner

Dr. Spencer Kennedy Smith , DDS

Dentist - General Practice • Keesler Afb, MS

Professional Overview & Biography Verified Profile Summary

Dr. Spencer Smith, DDS is a registered healthcare professional specializing in Dentist - General Practice in Keesler Afb, MS. Practice services are available at 301 FISHER ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

301 Fisher St

Keesler Afb, MS 395342508

Telephone 2283763060
Associated Practice Facility / Clinic
🏢 81st Medgrp-Keesler Facility NPI 1710967526

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Keesler Afb, MS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 20.3 Yrs
Regional Practice Density
7 Specialists

Practicing in Keesler Afb, MS (895 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: 2024-08-12
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MO 2019020377

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.

Secondary Practice Locations

18th Medical Group, Unit 5142

Apo, AP 963685142

Phone: 3156304902

Practice Associates & Co-Workers

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

1 Associated Practitioners
Francesca Gallucci

Physician Assistant - Medical

NPI 1316722143

Career & Practice History Timeline

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

13 Historical Events
📍
Updated Practice Location August 12, 2024

Registered at 301 FISHER ST, KEESLER AFB, MS 395342508 (Tel: 2283763060)

📍
Updated Business Mailing Address August 12, 2024

Registered at 301 FISHER ST, KEESLER AFB, MS 395342508

📍
Updated Business Mailing Address August 07, 2023

Registered at UNIT 5268, APO, AP 963685268 (Tel: 3156305300)

📍
Updated Practice Location September 10, 2020

Registered at 18TH MEDICAL GROUP, UNIT 5142, APO, AP 963685142 (Tel: 3156304902)

📍
Updated Business Mailing Address September 10, 2020

Registered at PSC 80 BOX 15647, APO, AP 963670059

👤
Provider Name / Credentials Updated September 10, 2020

Recorded as SPENCER SMITH, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 10, 2020

Dentist (License #2019020377 in MO)

NPI Profile Active March 29, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location March 29, 2019

Registered at 76 NEALY BLVD BLDG 92, HAMPTON, VA 236652022 (Tel: 7572257630)

📍
Updated Business Mailing Address March 29, 2019

Registered at 217 E 30TH ST, KANSAS CITY, MO 641083212 (Tel: 9136089434)

👤
Provider Name / Credentials Updated March 29, 2019

Recorded as SPENCER SMITH

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 29, 2019

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 29, 2019

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: 1255892394
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 29, 2019
Last Update: August 12, 2024
Sole Proprietor: No

Mailing Address

301 Fisher St

Keesler Afb, MS 395342508

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.