NPIMap

Organization Active NPI

Maxsurge Dental Specialist PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Harrison, AR
National Provider Identifier
1205255403
Registry record updated Apr 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
3025 Issued in AR
Legal business name
MAXSURGE DENTAL SPECIALIST PLLC
Practice address
520 N Pine St
Harrison, AR 72601-3442
Phone
(870) 741-3877
Fax
(870) 741-2406
NPI assigned
Apr 15, 2014
Last updated
Apr 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2014

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

Authorized official

Name
Dr. Scott L Bolding, DDS
Title
Owner
Phone
(479) 717-1171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 3025 AR Primary

Addresses

Primary practice location

520 N Pine St
Harrison, AR 72601-3442

Mailing address

PO Box 1481
Searcy, AR 72145-1481
Phone (479) 717-1171

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": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398038400000",
    "number": "1205255403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1481",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721451481",
            "telephone_number": "479-717-1171",
            "fax_number": "479-725-2395"
        },
        {
            "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 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-21",
        "status": "A",
        "authorized_official_last_name": "BOLDING",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-717-1171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AR",
            "license": "3025",
            "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 Apr 21, 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.