Mark W. Chunn, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3078 Issued in AR

Practice address

259 Eagle Mountain Blvd
Batesville, AR 72501-4232

Phone

(870) 698-0900

Fax

(870) 698-0332

NPI assigned

Oct 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• White River Dental Center Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• White River Dental Center

  • General Practice Dentistry
  • Batesville, AR
  • NPI 1720316359
  NPD (past) Authorized official
• Mark W. Chunn

  • General Practice Dentistry
  • Batesville, AR
  • NPI 1578151601
  NPD

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1073699542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 EAGLE MOUNTAIN BLVD",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725014232",
            "telephone_number": "870-698-0900",
            "fax_number": "870-698-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 EAGLE MOUNTAIN BLVD",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725014232",
            "telephone_number": "870-698-0900",
            "fax_number": "870-698-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNN",
        "first_name": "MARK",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3078",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260994631",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WHITE",
            "last_name": "DENTAL CENTER",
            "middle_name": "RIVER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Chase
• Dana Kathryn Childress, CNP
• Timothy Childress
• Whitney Dianne Childress, MHPP
• Stephanie Marie Choi, PA-C
• Amy Clark, COTA
• Beverly Lynn Clark, RN
• Heather Clark
• Shannon Clark, BSE
• Hailey Clay, AAS

• General Practice Dentistry in Batesville, AR
• Providers in Batesville, 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 Mar 16, 2021; 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.