Soh of Arkansas PLLC Samson Liu MBR

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOH OF ARKANSAS PLLC SAMSON LIU MBR

Doing business as

Marcus Black DDS

Practice address

2109 S 54TH St
Rogers, AR 72758-8169

Phone

(479) 464-0900

NPI assigned

Oct 29, 2018

Last updated

Oct 29, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

SOH OF ARKANSAS PLLC SAMSON LIU PLLCAs reported in NPPES

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

Authorized official

Name

Ray Weber

Title

Support Specialist

Phone

(314) 753-8154

Specialties & licenses 1

Addresses

Other names 1

• Marcus Black DDS Doing business as

Tax ID family

Soh of Arkansas PLLC Samson Liu MBR2 organizations share this tax ID, including this one

Part of

Soh of Arkansas PLLC Samson Liu MBR

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Soh of Arkansas PLLC Samson Liu MBR

  • General Practice Dentistry
  • Rogers, AR
  • NPI 1700361458
  NPD tax ID

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1033686084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 ELBRIDGE PAYNE RD STE 240",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630178544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 S 54TH ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588169",
            "telephone_number": "479-464-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOH OF ARKANSAS PLLC SAMSON LIU MBR",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOH OF ARKANSAS PLLC SAMSON LIU PLLC",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "SUPPORT SPECIALIST",
        "authorized_official_telephone_number": "314-753-8154"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marcus Black DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Braelyn Olivia Smorynski
• Alyssa Brianne Snow, PA-C
• Melia Snyder, LPC, LCMHC, PHD
• Laura Socha, RBT
• Adam F Socia, DDS
• Soh of Arkansas PLLC Samson Liu MBR
• Carly Solome
• Karen Sonora
• Daniel Ray Sorensen, PT, MSPT
• Alexandria Christine Sorenson

• General Practice Dentistry in Rogers, AR
• Providers in Rogers, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.