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DR. PAUL R SMITH DDS
NPI 1174582928
Dentist - Oral and Maxillofacial Surgery in Davenport, IA

Active since March 21, 2006Opted out of Medicare · through May 22, 2028
5345 SPRING STREET, DAVENPORT, IA 52807(563) 359-1601(563) 355-7111 Get Directions Write a Review

NPPES record last updated: July 8, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Paul R Smith Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PAUL R SMITH DDS (NPI 1174582928) is an individual oral and maxillofacial surgery provider in Davenport, Iowa, licensed in Iowa (7850) and active in the NPI registry since March 2006. He has opted out of Medicare through May 22, 2028.

NPPES Registry Identity

NPI1174582928
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. PAUL R SMITHCredential: DDS
Location Address5345 SPRING STREETDavenport, IA 52807-0000
Mailing Address5345 Spring StDavenport, IA 52807-2764 · (563) 359-1601 · Fax (563) 355-7111
Phone(563) 359-1601
Fax(563) 355-7111
Sole ProprietorNo
Enumeration DateMarch 21, 2006
Last NPPES UpdateJuly 8, 2010
✔ NPI 1174582928 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Licenses✔ Licensed in IA · 7850✔ Licensed in MD · 8846
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
5345 SPRING STREET, Davenport, IA 52807
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Other Identifiers 7

Medicaid0142778IA
Medicare UPINU62201IA
Medicare ID-Type Unspecified57072IA · Clinton Medicare #
Medicare ID-Type Unspecified05443IA · Davenport Medicaire #
Medicare UPIN54435
Medicaid142778IA
Medicaid2142778IA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Paul R Smith Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 22, 2020 through May 22, 2028.

Opt-Out Effective DateMay 22, 2020
Opt-Out In Effect ThroughMay 22, 2028Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paul Smith's NPI number?

The NPI number for Paul Smith is 1174582928. It was assigned to this individual provider in the NPPES registry on March 21, 2006.

Where is Paul Smith located?

Paul Smith practices at 5345 Spring Street, Davenport, IA 52807. The listed phone number is (563) 359-1601.

What is Paul Smith's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Paul Smith enrolled in Medicare?

No. Paul Smith has opted out of Medicare through May 22, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Paul Smith was last updated on July 8, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.