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AR DENTAL & TMJ - LITTLE ROCK LLC NPI 1508114067


NPI Information

NPI: 1508114067
Provider Name: AR DENTAL & TMJ - LITTLE ROCK, LLC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
12018 CHENAL PKWY
LITTLE ROCK, AR
ZIP 72211
Phone: (501) 225-1577
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AR DENTAL & TMJ - LITTLE ROCK, LLC is an oral and maxillofacial surgery dentist in Little Rock, AR. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. AR DENTAL & TMJ - LITTLE ROCK, LLC NPI is 1508114067. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12018 CHENAL PKWY
LITTLE ROCK, AR
ZIP 72211-759
Phone: (501) 225-1577
Fax: (501) 219-4780

The provider's authorized official is Erin Cupan .
The authorized official title is Practice Administrator and has the following contact phone number (501) 225-1577.

The enumeration date for this NPI number is 8/15/2012 and was last updated on 8/15/2012.


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
11223S0112XDentistOral and Maxillofacial Surgery3396ARKANSASYes

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
1192473680MEDICAIDARKANSAS

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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