Individual provider Active NPI

Janette Nagrampa, DDS

  • Dentist
  • Fort Smith, AR
National Provider Identifier
1083274823
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4351 Issued in AR
Practice address
2913 S 74TH St
Fort Smith, AR 72903-5156
Phone
(479) 484-5050
NPI assigned
Jun 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4351 AR Primary

Addresses

Primary practice location

2913 S 74TH St
Fort Smith, AR 72903-5156

Mailing address

2913 S 74TH St
Fort Smith, AR 72903-5156
Phone (479) 484-5050

Other practice location 1

230 N Elmira Ave
Russellville, AR 72802-9617
Phone (479) 280-1920

Other identifiers 1

IdentifierTypeStateIssuer
235343608MedicaidAR

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

LicenseStateTypeSpecialty
4351ARMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Dental Care CurrentSince Nov 15, 2020 Accepting new patients
Dental Health Associates of Arkansas, P.a. Past Accepting new patients

Locations

2913 S 74th St
Fort Smith, AR 72903
Phone (479) 484-5050

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1083274823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2913 S 74TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035156",
            "telephone_number": "479-484-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2913 S 74TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035156",
            "telephone_number": "479-484-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 N Elmira Ave",
            "address_purpose": "LOCATION",
            "city": "Russellville",
            "state": "AR",
            "postal_code": "728029617",
            "country_code": "US",
            "telephone_number": "479-280-1920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAGRAMPA",
        "first_name": "JANETTE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "4351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "235343608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.