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PRECIDENT PLLC NPI 1588176630


NPI Information

NPI: 1588176630
Provider Name: PRECIDENT, PLLC

Former Legal Business Name: INTEGRATIVE DENTAL SPECIALISTS PLLC

Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

CLIA Number: 04D2144969

Address:
3333 S PINNACLE HILLS PKWY STE 140
ROGERS, AR
ZIP 72758
Phone: (479) 755-3000
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PRECIDENT, PLLC is an oral and maxillofacial surgery dentist in Rogers, 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. PRECIDENT, PLLC NPI is 1588176630. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Integrative Dental Specialists Pllc.

The provider's business location address is:

3333 S PINNACLE HILLS PKWY STE 140
ROGERS, AR
ZIP 72758-953
Phone: (479) 755-3000
Fax: (479) 616-1914

The provider's authorized official is Scotty L Bolding .
The authorized official title is Owner and has the following contact phone number (479) 957-4611.

The CLIA number assigned to this NPI record is 04D2144969 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/30/2017 and was last updated on 10/11/2022.


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
11223S0112XDentistOral and Maxillofacial Surgery3025ARKANSASNo
2204E00000XOral & Maxillofacial SurgeryNo
31223S0112XDentistOral and Maxillofacial SurgeryYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.