NPIMap

Organization Active NPI

Higginbotham Dental Group, PLLC

  • General Practice Dentistry
  • Jonesboro, AR
National Provider Identifier
1124263579
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3393 Issued in AR
Legal business name
HIGGINBOTHAM DENTAL GROUP, PLLC
Practice address
321 Southwest Dr
Jonesboro, AR 72401-5854
Phone
(870) 932-8585
Fax
(870) 932-0949
NPI assigned
Dec 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Authorized official

Name
Misti Ross
Title
Insurance Director
Phone
(870) 336-3732

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 3393 AR Primary

Addresses

Primary practice location

321 Southwest Dr
Jonesboro, AR 72401-5854

Mailing address

1804 Old Greensboro Rd BLDG B
Jonesboro, AR 72405-0003
Phone (870) 336-3732

Other names 1

  • Higginbotham Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Higginbotham Dental Group PLLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

321 Southwest Dr
Jonesboro, AR 72401
Phone (870) 243-1808

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602633600000",
    "number": "1124263579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 OLD GREENSBORO RD BLDG B",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724050003",
            "telephone_number": "870-336-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 SOUTHWEST DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015854",
            "telephone_number": "870-932-8585",
            "fax_number": "870-932-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGGINBOTHAM DENTAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-12",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "MISTI",
        "authorized_official_title_or_position": "INSURANCE DIRECTOR",
        "authorized_official_telephone_number": "870-336-3732"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Higginbotham Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.