1073175956 NPI number — SAVIDA HEALTH, PC

Table of content: DR. BRUCE ELLIOT SMITH D.D.S. (NPI 1255322210)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073175956 NPI number — SAVIDA HEALTH, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAVIDA HEALTH, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073175956
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/05/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 291943
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37229-1943
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
833-952-0829
Provider Business Mailing Address Fax Number:
615-237-1434

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4421 ROOSEVELT BLVD STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45044-9024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
833-356-4080
Provider Business Practice Location Address Fax Number:
615-237-1434
Provider Enumeration Date:
07/01/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MAHONEY
Authorized Official First Name:
MARINA
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OF REVENUE CYCLE MANAGEMENT
Authorized Official Telephone Number:
913-213-1084

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RA0401X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)