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ORAL SURGERY OF CENTRAL ARKANSAS NPI 1245829027


NPI Information

NPI: 1245829027
Provider Name: ORAL SURGERY OF CENTRAL ARKANSAS
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
4701 FAIRWAY AVE STE D
NORTH LITTLE ROCK, AR
ZIP 72116
Phone: (501) 791-7600
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ORAL SURGERY OF CENTRAL ARKANSAS is an oral and maxillofacial surgery dentist in North 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. ORAL SURGERY OF CENTRAL ARKANSAS NPI is 1245829027. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4701 FAIRWAY AVE STE D
NORTH LITTLE ROCK, AR
ZIP 72116-069
Phone: (501) 791-7600
Fax: (501) 791-2824

The provider's authorized official is Jennifer Patterson .
The authorized official title is Office Manager and has the following contact phone number (013) 275-2555.

The enumeration date for this NPI number is 1/15/2021 and was last updated on 1/18/2021.


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 SurgeryYes

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
1200352679MEDICAIDARKANSAS

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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