Active NPI
Djuana Leigh Cartillar, D.D.S.
- Pediatric Dentistry
- Forrest City, AR
National Provider Identifier
1003981283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 3045
- Practice address
- 4941 North Washington/Highway1
Forrest City, AR 72335 - Phone
- (870) 630-1500
- Fax
- (870) 630-6405
- NPI assigned
- Nov 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 3045 | AR | Primary |
Addresses
Primary practice location
4941 North Washington/Highway1
Forrest City, AR 72335
Mailing address
4941 North Washington/Highway 1
Forrest City, AR 72335
Phone (870) 630-1500
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 59632 | Other | AR | BCBS PROVIDER # |
| 123626608 | Medicaid | AR | |
| 710851189 | Other | AR | TAX IDENTIFICATION NUMBER |
| 862131 | Other | AR | UNITED CONCORDIA NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3045 | AR | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188259200000",
"number": "1003981283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4941 NORTH WASHINGTON/HIGHWAY 1",
"city": "FORREST CITY",
"state": "AR",
"postal_code": "72335",
"telephone_number": "870-630-1500",
"fax_number": "870-630-6405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4941 NORTH WASHINGTON/HIGHWAY1",
"city": "FORREST CITY",
"state": "AR",
"postal_code": "72335",
"telephone_number": "870-630-1500",
"fax_number": "870-630-6405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTILLAR",
"first_name": "DJUANA",
"middle_name": "LEIGH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-22",
"last_updated": "2007-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "AR",
"license": "3045",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER #",
"identifier": "59632",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "123626608",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION NUMBER",
"identifier": "710851189",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA NUMBER",
"identifier": "862131",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forrest City, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.