Active NPI
Miranda Michelle Childs, D.D.S.
- General Practice Dentistry
- Arkadelphia, AR
National Provider Identifier
1043325145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3103
- Practice address
- 312 Professional Park Dr
Suite D
Arkadelphia, AR 71923-5315 - Phone
- (870) 245-2323
- Fax
- (270) 245-2368
- NPI assigned
- Aug 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3103 | AR | Primary |
Addresses
Primary practice location
312 Professional Park Dr
Suite D
Arkadelphia, AR 71923-5315
Mailing address
312 Professional Park Dr
Suite D
Arkadelphia, AR 71923-5315
Phone (870) 245-2323
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5U242 | Other | AR | BLUE CROSS BLUE SHIELD PR |
| 766360 | Other | AR | UNITED CONCORDIA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3103 | AR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miranda M Childs DDS | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Arkadelphia, AR
- NPI 1891987061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043325145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 PROFESSIONAL PARK DR",
"address_2": "SUITE D",
"city": "ARKADELPHIA",
"state": "AR",
"postal_code": "719235315",
"telephone_number": "870-245-2323",
"fax_number": "270-245-2368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 PROFESSIONAL PARK DR",
"address_2": "SUITE D",
"city": "ARKADELPHIA",
"state": "AR",
"postal_code": "719235315",
"telephone_number": "870-245-2323",
"fax_number": "270-245-2368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDS",
"first_name": "MIRANDA",
"middle_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "3103",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD PR",
"identifier": "5U242",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "766360",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arkadelphia, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.