James Douglas Allen, DDS
Individual provider Active NPI General Practice Dentistry · Dewitt, AR
NPI 1013076397 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1013076397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 3490 (AR)
- Practice address
- 1703 S Whitehead Dr
Dewitt, AR 72042 - Phone
- (870) 946-2013
- Fax
- (870) 946-1281
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160302001926 | AR | Order and Referring Only - Dentist |
4082910906 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3490 | AR | MD | General Practice Dentistry |
Networks
- devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
- MS PPO D-SNP
- TN PPO C-SNP
- devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
- MS PPO C-SNP
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3490 | AR | Yes |
Addresses
Primary practice location
1703 S Whitehead Dr
Dewitt, AR 72042
Mailing address
PO Drawer 512
1703 S Whitehead Dr
Dewitt, AR 72042
Phone (870) 946-2013
Other providers in Dewitt, AR
- Baptist Health Hospitals
- Suzette Nicole Boyd
- Stanley Wayne Burleson
- Alton Chambless
- Deans Pharmacies, Inc.
All providers in Dewitt, AR · General Practice Dentistry in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.