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BENTON FAMILY DENTISTRY NPI 1134646698


NPI Information

NPI: 1134646698
Provider Name: BENTON FAMILY DENTISTRY
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
1200 FERGUSON DR STE 4
BENTON, AR
ZIP 72015
Phone: (501) 317-7544
Get Directions

BENTON FAMILY DENTISTRY is a general practice dentist in Benton, AR. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. BENTON FAMILY DENTISTRY NPI is 1134646698. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1200 FERGUSON DR STE 4
BENTON, AR
ZIP 72015-947
Phone: (501) 317-7544

The provider's authorized official is Justin C Bethel .
The authorized official title is Owner and has the following contact phone number (501) 317-7544.

The enumeration date for this NPI number is 8/25/2017 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice3339ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11861885515MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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