Smith, Brian Keith
Smith, Brian Keith is an sole proprietor health care provider with primary practice located at 14701 Detroit Ave #333, Lakewood OH 44107-4115. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Smith, Brian Keith can be contacted via phone (216) 228-4232.Contact Information
Primary practice address
14701 Detroit Ave #333
Lakewood OH 44107-4115
Phone: (216) 228-4232
Fax: (216) 228-9136
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 30018374 | Ohio |
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 35067574S | Ohio |
Profile Details
| NPI number | 1831188077 |
|---|---|
| LBN Legal business name | Smith, Brian Keith |
| Credentials | DDS MD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 20th, 2005 |
| Last updated | Jan 28th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831188077 | NPPES |
| Ohio | MEDICAID | 0811545 | |
| Ohio | Other | 150972 | |
| Ohio | Other | 605876 | |
| Ohio | Other | 000000141822 |
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