NPIMap

Organization Active NPI

Maxsurge Dental Specialist

  • General Practice Dentistry
  • Harrison, AR
National Provider Identifier
1134526106
Registry record updated Nov 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MAXSURGE DENTAL SPECIALIST
Practice address
520 N Pine St
Harrison, AR 72601-3442
Phone
(870) 741-3877
Fax
(870) 741-2406
NPI assigned
Nov 19, 2014
Last updated
Nov 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2014

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

Authorized official

Name
Scott Bolding, DDS, MS
Title
Owner
Phone
(479) 582-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

520 N Pine St
Harrison, AR 72601-3442

Mailing address

520 N Pine St
Harrison, AR 72601-3442
Phone (870) 741-3877

National Provider Directory

National Provider Directory
Tax ID family
Maxsurge Dental Specialist2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416355200000",
    "number": "1134526106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N PINE ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726013442",
            "telephone_number": "870-741-3877",
            "fax_number": "870-741-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N PINE ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726013442",
            "telephone_number": "870-741-3877",
            "fax_number": "870-741-2406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXSURGE DENTAL SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-19",
        "last_updated": "2014-11-19",
        "status": "A",
        "authorized_official_last_name": "BOLDING",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-582-3000",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; 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.