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DR. JACK BRIAN SMITH DMD
NPI 1356489462
Dentist - Endodontics in Rome, GA

Active since February 01, 2007PECOS Enrolled
160 THREE RIVERS DR NE, STE. 1600, ROME, GA 30161(706) 291-0095(706) 291-0036 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jack Brian Smith Dmd NPPES

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

DR. JACK BRIAN SMITH DMD (NPI 1356489462) is an individual endodontics provider in Rome, Georgia, licensed in Georgia (DN012910) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356489462
Entity TypeIndividualMale
Primary Taxonomy1223E0200X
Provider Legal NameDR. JACK BRIAN SMITHCredential: DMD
Location Address160 THREE RIVERS DR NE, STE. 1600Rome, GA 30161-2303
Mailing Address41 Dover Dr SeRome, GA 30161-8015 · (423) 309-6816
Phone(706) 291-0095
Fax(706) 291-0036
Sole ProprietorYes
Enumeration DateFebruary 1, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1356489462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · EndodonticsDental Providers
Taxonomy Code1223E0200X
License✔ Licensed in GA · DN012910
Definition
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
160 THREE RIVERS DR NE, Rome, GA 30161
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jack Brian Smith Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30161 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KARA HICKS
Counselor (Professional)
160 THREE RIVERS DR NE
ROME, GA 30161
Floyd County (706) 622-3681
DR. SAMUEL JAMES MUMPOWER D.M.D.
Dentist (Endodontics)
160 THREE RIVERS DR NE, SUITE 1600
ROME, GA 30161
Floyd County (706) 291-0095
HEARING AND BALANCE HEALTHCARE, INC.
Audiologist
160 THREE RIVERS DR NE, STE 800
ROME, GA 30161
Floyd County (706) 232-2432

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 Jack Smith's NPI number?

The NPI number for Jack Smith is 1356489462. It was assigned to this individual provider in the NPPES registry on February 1, 2007.

Where is Jack Smith located?

Jack Smith practices at 160 Three Rivers Dr NE Ste. 1600, Rome, GA 30161. The listed phone number is (706) 291-0095.

What is Jack Smith's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Is Jack Smith enrolled in Medicare?

Yes. Jack Smith is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Smith was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.