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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831188077 NPPES
Ohio MEDICAID 0811545
Ohio Other 150972
Ohio Other 605876
Ohio Other 000000141822

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