Donathan Scott Kimbrough

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3706 Issued in AR

Practice address

2702 American St
Springdale, AR 72764-6937

Phone

(479) 751-9899

Fax

(479) 751-8705

NPI assigned

Jul 2, 2009

Last updated

Jul 15, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Randal S Kimbrough DDS PA

  • General Practice Dentistry
  • Springdale, AR
  • NPI 1447340450
  NPD (past)
• Randal S. Kimbrough

  • General Practice Dentistry
  • Springdale, AR
  • NPI 1174879894
  NPD (past)

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247616000000",
    "number": "1063641736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 AMERICAN ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727646937",
            "telephone_number": "479-751-9899",
            "fax_number": "479-751-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 AMERICAN ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727646937",
            "telephone_number": "479-751-9899",
            "fax_number": "479-751-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBROUGH",
        "first_name": "DONATHAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2009-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kinzie Kight
• Wina Kijenmij
• Drew S Killingsworth
• Michele R Kilmer, PNP
• Kimberly a. Owens, Optometric Physician, PA
• Jonathan Kimbrough, CNIM
• Randal Shepard Kimbrough, D.D.S.
• Kimlor Medical Supply
• Israel Kincy
• Rachel Blair Kindhart

• General Practice Dentistry in Springdale, AR
• Providers in Springdale, 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 Jul 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.