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PINNACLE PERIODONTICS NPI 1396189270


NPI Information

NPI: 1396189270
Provider Name: PINNACLE PERIODONTICS

Doing Business As: PINNACLE PERIODONTICS & DENTAL IMPLANT CENTER

Classification: Dentist - 1223P0300X
Entity Type: Organization

Specialization: Periodontics

Address:
1225 BRECKENRIDGE DR
#110
LITTLE ROCK, AR
ZIP 72205
Phone: (501) 225-4644
Get Directions

PINNACLE PERIODONTICS is a periodontics dentist in Little Rock, AR. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. PINNACLE PERIODONTICS NPI is 1396189270. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Pinnacle Periodontics & Dental Implant Center.

The provider's business location address is:

1225 BRECKENRIDGE DR
#110
LITTLE ROCK, AR
ZIP 72205-558
Phone: (501) 225-4644
Fax: (501) 225-4102

The provider's authorized official is Matthew D Carlisle .
The authorized official title is Owner/periodontist and has the following contact phone number (501) 225-4644.

The enumeration date for this NPI number is 4/23/2013 and was last updated on 4/23/2013.


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
11223P0300XDentistPeriodontics3613ARKANSASYes

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
1195700679MEDICAIDARKANSAS

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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