Kimberly D Smith, DDS is a medicare enrolled "Dentist - General Practice" provider in Ridgeway, South Carolina. Her current practice location is
755 Us Highway 21 S, Ridgeway, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(803) 337-2920.
Kimberly D Smith is licensed to practice in South Carolina (license number 4291) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1912120023.
Healthcare Provider's Profile
| Full Name | Kimberly D Smith |
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| Gender | Female |
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| Speciality | Dentist - General Practice |
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| Location | 755 Us Highway 21 S, Ridgeway, South Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1912120023
- Provider Enumeration Date: 04/10/2007
- Last Update Date: 01/26/2021
Medicare PECOS Information:
- PECOS PAC ID: 4385057074
- Enrollment ID: I20210129000328
Medical Identifiers
Medical identifiers for Kimberly D Smith such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1912120023 | NPI | - | NPPES |
| 599440686A | Medicaid | GA | |
| ZX4291 | Medicaid | SC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | DN013063 (Georgia) | Secondary |
| 1223G0001X | Dentist - General Practice | 4291 (South Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kimberly D Smith allows following entities to bill medicare on her behalf.
| Entity Name | Eau Claire Cooperative Health Center, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1346249430
PECOS PAC ID: 3274434220
Enrollment ID: O20040114000335 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly D Smith is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kimberly D Smith, DDS
755 Us Highway 21 S,
Ridgeway, SC 29130-6844
Ph: (803) 337-2920 | Kimberly D Smith, DDS
755 Us Highway 21 S,
Ridgeway, SC 29130-6844
Ph: (803) 337-2920 |
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