Individual
JODIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
60 SUNRISE HWY # 60, LINDENHURST, NY 11757-2505
(631) 296-1124
Mailing address
462 FIRST AVENUE, NEW YORK, NY 10016
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
062616
NY
122300000X
Dentist
22D102878500
NJ
Other
Enumeration date
04/12/2021
Last updated
05/13/2025
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