Active NPI
George Scott Puryear Jr., D.D.S.
- General Practice Dentistry
- Wynne, AR
National Provider Identifier
1073683827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2218
- Practice address
- 715 E. Eldridge Ave
Wynne, AR 72396 - Phone
- (870) 238-3628
- Fax
- (870) 238-0757
- NPI assigned
- Nov 9, 2006
- Last updated
- Oct 12, 2016
- Sex
- Male
- 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 | 2218 | AR | Primary |
Addresses
Primary practice location
715 E. Eldridge Ave
Wynne, AR 72396
Mailing address
715 Eldridge Ave E
715 E. Eldridge Ave
Wynne, AR 72396-4032
Phone (870) 238-3628
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3101742 | Other | AR | TNBCBS |
| 58710 | Other | AR | ARBCBS |
| 102044608 | Medicaid | AR | |
| 842108 | Other | AR | UNITED CONCORDIA |
Other names 1
- Dr. Scott Puryear
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2218 | AR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476230400000",
"number": "1073683827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 ELDRIDGE AVE E",
"address_2": "715 E. ELDRIDGE AVE",
"city": "WYNNE",
"state": "AR",
"postal_code": "723964032",
"telephone_number": "870-238-3628",
"fax_number": "870-238-0757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 E. ELDRIDGE AVE",
"city": "WYNNE",
"state": "AR",
"postal_code": "72396",
"telephone_number": "870-238-3628",
"fax_number": "870-238-0757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURYEAR",
"first_name": "GEORGE",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2016-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "2218",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TNBCBS",
"identifier": "3101742",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARBCBS",
"identifier": "58710",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102044608",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "842108",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SCOTT",
"last_name": "PURYEAR",
"prefix": "DR.",
"credential": "D.D.S.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Wynne, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.