W.Darrel Fain D.D.S. P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2114 Issued in AR

Legal business name

W.DARREL FAIN D.D.S. P.A.

Practice address

419 E 6TH St S
Prescott, AR 71857-2432

Phone

(870) 887-5051

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

William Darrel Fain

Title

Owner

Phone

(870) 887-5051

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1194886291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 E 6TH ST S",
            "city": "PRESCOTT",
            "state": "AR",
            "postal_code": "718572432",
            "telephone_number": "870-887-5051",
            "fax_number": "870-887-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 E 6TH ST S",
            "city": "PRESCOTT",
            "state": "AR",
            "postal_code": "718572432",
            "telephone_number": "870-887-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W.DARREL FAIN D.D.S. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "FAIN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DARREL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-887-5051"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116984831",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "2114",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "58267",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca A Trevillion
• Kimberly Janet Tye, LPN
• Carol G Underwood
• VBNC Ops, Inc.
• Charles A. Vermont, M.D.
• Aubrey Walker, QBHP
• Alicia L Washington
• Lacy Watts
• Lakyn Danielle Watts, PTA
• Stacie A Webb

• General Practice Dentistry in Prescott, AR
• Providers in Prescott, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.