Individual provider Active NPI

Bobby L. Arnold, D.D.S.

  • Dentist
  • Austin, TX
National Provider Identifier
1023449154
Registry record updated Nov 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14458 Issued in TX
Practice address
3724 Jefferson St Ste 100
Austin, TX 78731-6219
Phone
(512) 452-4661
NPI assigned
Nov 27, 2013
Sex
Male
Sole proprietor
Yes

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

LicenseStateTypeSpecialty
14458TXMDDentist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14458 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

3724 Jefferson St Ste 100
Austin, TX 78731-6219

Mailing address

3724 Jefferson St Ste 100
Austin, TX 78731-6219
Phone (512) 452-4661

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1124247242OtherTXNPI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 27, 2013.

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385510400000",
    "number": "1023449154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 JEFFERSON ST STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316219",
            "telephone_number": "512-452-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3724 JEFFERSON ST STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316219",
            "telephone_number": "512-452-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "BOBBY",
        "middle_name": "L.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-27",
        "last_updated": "2013-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "14458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1124247242",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.