Individual provider Active NPI

William Allyn Ladd, DDS

  • Dentist
  • Camden, AR
National Provider Identifier
1114009636
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1085 Issued in AK
Practice address
540 Jefferson St SW
Camden, AR 71701-3952
Phone
(870) 836-8944
Fax
(870) 836-8984
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1085 AK Primary
General Practice Dentistry 1223G0001X 3328 AR

Addresses

Primary practice location

540 Jefferson St SW
Camden, AR 71701-3952

Mailing address

540 Jefferson St SW
Camden, AR 71701-3952
Phone (870) 836-8944

Other identifiers 3

IdentifierTypeStateIssuer
181029631MedicaidAR
2056123OtherARUNITED CONCORDIA
5H250OtherARBCBS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180208001075 AR Order and Referring Only - DentistPractitioner - Dentist 9830459031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3328ARMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ladd Dental, PA Past Accepting new patients

Organizations & group practices 1

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1114009636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 JEFFERSON ST SW",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717013952",
            "telephone_number": "870-836-8944",
            "fax_number": "870-836-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 JEFFERSON ST SW",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717013952",
            "telephone_number": "870-836-8944",
            "fax_number": "870-836-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADD",
        "first_name": "WILLIAM",
        "middle_name": "ALLYN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "1085",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3328",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181029631",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "2056123",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5H250",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, AR

Sources for this page

Verify at the official NPI Registry.