Individual provider Active NPI

Lance Alan McGraw, D.D.S.

  • General Practice Dentistry
  • Beebe, AR
National Provider Identifier
1013930163
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3015 Issued in AR
Practice address
1010 W Center St
Beebe, AR 72012-3165
Phone
(501) 882-3835
Fax
(501) 882-0535
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3015 AR Primary

Addresses

Primary practice location

1010 W Center St
Beebe, AR 72012-3165

Mailing address

1010 W Center St
Beebe, AR 72012-3165
Phone (501) 882-3835

Other identifiers 2

IdentifierTypeStateIssuer
811725OtherARUNITED CONCORDIA
58608OtherARBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141119000295 AR Order and Referring Only - Maxillofacial SurgeryPractitioner - Maxillofacial Surgery 6800018227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3015ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lance a. McGraw, D.D.S., PLLC General Practice CurrentSince Feb 14, 2021 Accepting new patients
LD McGraw, DDS, PLLC Past Accepting new patients

Locations

1010 W Center St
Beebe, AR 72012
Phone (501) 882-3540

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1013930163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W CENTER ST",
            "city": "BEEBE",
            "state": "AR",
            "postal_code": "720123165",
            "telephone_number": "501-882-3835",
            "fax_number": "501-882-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W CENTER ST",
            "city": "BEEBE",
            "state": "AR",
            "postal_code": "720123165",
            "telephone_number": "501-882-3835",
            "fax_number": "501-882-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRAW",
        "first_name": "LANCE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "811725",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "58608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beebe, AR

Sources for this page

Verify at the official NPI Registry.