Puckett Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

3406 Issued in AR

Legal business name

PUCKETT DENTAL LLC

Doing business as

Pocahontas Smiles

Practice address

1041 Highway 67 North
Pocahontas, AR 72455

Phone

(870) 236-5888

NPI assigned

Jul 10, 2015

Last updated

Jul 10, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

PUCKETT DENTAL LLCAs reported in NPPES

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

Authorized official

Name

Dr. John Hartley Puckett, D.D.S.NPI 1013993492

Title

Owner

Phone

(870) 236-5888

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Pocahontas Smiles Doing business as

Part of

Puckett Dental LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Puckett Dental LLC

  dba Ridge Kids Dental

  • Dentist
  • Paragould, AR
  • NPI 1669608741
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John H. Puckett, D.D.S.

  • General Practice Dentistry
  • Pargould, AR
  • NPI 1013993492
  Authorized official Same address or phone

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436486400000",
    "number": "1043694920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041HWY. 67 N.",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "72455",
            "telephone_number": "870-236-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 HIGHWAY 67 NORTH",
            "city": "POCAHONTAS",
            "state": "AR",
            "postal_code": "72455",
            "telephone_number": "870-236-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUCKETT DENTAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUCKETT DENTAL LLC",
        "enumeration_date": "2015-07-10",
        "last_updated": "2015-07-10",
        "status": "A",
        "authorized_official_last_name": "PUCKETT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "HARTLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-236-5888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AR",
            "license": "4053",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AR",
            "license": "3684",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AR",
            "license": "3406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176096608",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669608741",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pocahontas Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Premier Home Care, LLC.
• April Kurriee Presson, LMT
• Alyson Nicole Prichard, DPT
• Leah Christen Privett, A.P.N.
• Public Building Authority of the City of Pocahontas Arkansas (Randolph County ER Group)
• Angela D Quest-Allen, LPC
• Katie Radcliff
• Randolph County Chiropractic, LLC
• Randolph County Clinic Corp (Pocahontas Healthcare Specialists)
• Randolph County Nursing Home (Randolph Home)

• Dental Clinic/Center in Pocahontas, AR
• Providers in Pocahontas, AR by specialty
• Dental Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.