Individual provider Active NPI

Samuel Cason, DDS

  • General Practice Dentistry
  • Little Rock, AR
National Provider Identifier
1164928883
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4303 Issued in AR
Practice address
9801 Stagecoach Rd
Little Rock, AR 72210-5737
Phone
(501) 455-6100
NPI assigned
Apr 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4303 AR Primary

Addresses

Primary practice location

9801 Stagecoach Rd
Little Rock, AR 72210-5737

Mailing address

9801 Stagecoach Rd
Little Rock, AR 72210-5737
Phone (501) 455-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 19, 2023 through Dec 19, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4303ARMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Harris and Reynolds Family Dental General Practice CurrentSince Jun 12, 2022 Accepting new patients

Locations

9801 Stagecoach Rd
Little Rock, AR 72210
Phone (501) 455-6100

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1164928883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 STAGECOACH RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722105737",
            "telephone_number": "501-455-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 STAGECOACH RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722105737",
            "telephone_number": "501-455-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASON",
        "first_name": "SAMUEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "4303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.