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JENNIFER MICHELLE WALLER-SMITH DDS
NPI 1720389794
Dentist in Choctaw, MS

Active since November 08, 2010PECOS Enrolled
210 HOSPITAL CIR, CHOCTAW, MS 39350(601) 656-2211(601) 663-7721 Get Directions Write a Review

NPPES record last updated: November 8, 2010. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jennifer Michelle Waller-smith Dds NPPES

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

JENNIFER MICHELLE WALLER-SMITH DDS (NPI 1720389794) is an individual dentist in Choctaw, Mississippi, licensed in Missouri (2010020016) and active in the NPI registry since November 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720389794
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameJENNIFER MICHELLE WALLER-SMITHCredential: DDS
Location Address210 HOSPITAL CIRChoctaw, MS 39350-6781
Mailing Address210 Hospital CirChoctaw, MS 39350-6781 · (601) 656-2211 · Fax (601) 663-7721
Phone(601) 656-2211
Fax(601) 663-7721
Sole ProprietorNo
Enumeration DateNovember 8, 2010
✔ NPI 1720389794 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MO · 2010020016
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
210 HOSPITAL CIR, Choctaw, MS 39350
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Michelle Waller-smith Dds 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.

Medicare Billing Reassignment

Medicare enrollment records show Jennifer Waller-smith reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

The Board Of Trustees Of The University Of Illinois
632 mi
Federally Qualified Health Center (FQHC)
1220 S. WOOD STREET, UIH-MILE SQUARE HEALTH CENTER
Chicago, IL 60608
  • Reassigned Medicare billing, Illinois enrollment
  • 113 clinicians in this Medicare group
NPI 1669493466 (312) 413-1261

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39350 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
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$64.96 typical visit price
range $16.15 – $129.61
Typical copayment $16.24 (range $4.03 – $32.40)
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 20

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

MR. EDDIE D RUTHERFORD RPH
Pharmacist
210 HOSPITAL CIR
CHOCTAW, MS 39350
Neshoba County (601) 389-4330
LINDA MURRAY FNP
Nurse Practitioner
210 HOSPITAL CIR
CHOCTAW, MS 39350
Neshoba County (601) 656-2211
JESSICA NICHOLE BLACK
Registered Nurse (Psychiatric/Mental Health)
210 HOSPITAL CIR
CHOCTAW, MS 39350
Neshoba County (601) 389-4150
MS BAND OF CHOCTAW INDIANS
Case Manager/Care Coordinator
210 HOSPITAL CIR
CHOCTAW, MS 39350
Neshoba County (601) 656-2211
DR. STEVEN KORY CULPEPPER PHARM.D.
Pharmacist
210 HOSPITAL CIR
CHOCTAW, MS 39350
Neshoba County (601) 389-4300
MRS. PENNY WEST DICKERSON RD
Dietitian, Registered
210 HOSPITAL CIR
CHOCTAW, MS 39350
Neshoba County (601) 389-4132
MISSISSIPPI BAND OF CHOCTAW INDIANS
Dentist
210 HOSPITAL CIR
CHOCTAW, MS 39350
Neshoba County (601) 389-6342
JESSICA W MOONEY PHARMACIST
Pharmacist
210 HOSPITAL CIR
CHOCTAW, MS 39350
Neshoba County (601) 656-2211

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 Jennifer Waller-smith's NPI number?

The NPI number for Jennifer Waller-smith is 1720389794. It was assigned to this individual provider in the NPPES registry on November 8, 2010.

Where is Jennifer Waller-smith located?

Jennifer Waller-smith practices at 210 Hospital Cir, Choctaw, MS 39350. The listed phone number is (601) 656-2211.

What is Jennifer Waller-smith's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Jennifer Waller-smith enrolled in Medicare?

Yes. Jennifer Waller-smith is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jennifer Waller-smith's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Waller-smith reassigns Medicare benefits to The Board Of Trustees Of The University Of Illinois (Chicago, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jennifer Waller-smith's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jennifer Waller-smith accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 7 other insurers list Jennifer Waller-smith as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jennifer Waller-smith was last updated on November 8, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.