Bethel Burris Oliver PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

BETHEL BURRIS OLIVER PLLC

Doing business as

Arkansas Dentistry and Braces

Practice address

1400 SE Walton Blvd
Suite 10-12
Bentonville, AR 72712-3722

Phone

(479) 445-6335

Fax

(479) 301-2878

NPI assigned

Apr 29, 2015

Last updated

Apr 29, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin G Burris, DDS, MDS, PA

Title

Owner

Phone

(479) 445-6335

Specialties & licenses 4

Addresses

Other names 1

• Arkansas Dentistry and Braces Doing business as

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1023495074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 N VANTAGE DR",
            "address_2": "SUITE 202",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034982",
            "telephone_number": "479-445-6335",
            "fax_number": "479-301-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 SE WALTON BLVD",
            "address_2": "SUITE 10-12",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123722",
            "telephone_number": "479-445-6335",
            "fax_number": "479-301-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL BURRIS OLIVER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "BURRIS",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-445-6335",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MDS, PA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arkansas Dentistry and Braces",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.