Charles Coon, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4728 Issued in AR

Practice address

701 NW McNelly Rd Ste 13
Bentonville, AR 72712-9160

Phone

(517) 648-4503

NPI assigned

Jun 15, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Charles F Coon DDS PLLC

  • Dental Clinic/Center
  • Bentonville, AR
  • NPI 1336907195
  NPD Authorized official
• Dental Associates of Madison, LLC

  • Dentist
  • Madison, AL
  • NPI 1952543779
  NPD (past)
• Hawkins McCaghren Partnership

  • General Practice Dentistry
  • Decatur, AL
  • NPI 1265581268
  NPD (past)

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1164090346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 SOMERVILLE RD SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356015015",
            "telephone_number": "256-355-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 NW MCNELLY RD STE 13",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727129160",
            "telephone_number": "517-648-4503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4072 Sullivan St Ste A",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "AL",
            "postal_code": "357583153",
            "country_code": "US",
            "telephone_number": "256-772-9988",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 Hine St S",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "AL",
            "postal_code": "356112323",
            "country_code": "US",
            "telephone_number": "256-232-1404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1815 Somerville Rd SE",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "AL",
            "postal_code": "356015015",
            "country_code": "US",
            "telephone_number": "256-355-2275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COON",
        "first_name": "CHARLES",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-15",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "D-0006888-C1",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2023034426",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "4728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Scott Conrad
• Dianne Lee Conroy, LPC
• Allisyn Converse
• Jennifer Conyac
• Margaret G Cook
• William Coones
• Aritney B Cooper
• Lela Cooper, RRT
• Tabitha Dawn Cooper, OTR/L
• Carolett Cooperstein, MHPP

• Dentist in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; 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.