Active NPI
Bradley David Becker, D.D.S.
- General Practice Dentistry
- Fort Smith, AR
National Provider Identifier
1215192000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3503
- Practice address
- 3600 Old Greenwood Rd
Suite 2
Fort Smith, AR 72903-5929 - Phone
- (479) 646-0706
- Fax
- (479) 646-0502
- NPI assigned
- Jul 22, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3503 | AR | Primary |
Addresses
Primary practice location
3600 Old Greenwood Rd
Suite 2
Fort Smith, AR 72903-5929
Mailing address
3600 Old Greenwood Rd
Suite 2
Fort Smith, AR 72903-5929
Phone (479) 646-0706
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 159196608 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3503 | AR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bradley D Becker DDS PA | General Practice | Past | Accepting new patients |
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": "1216684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220832000000",
"number": "1215192000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 OLD GREENWOOD RD",
"address_2": "SUITE 2",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729035929",
"telephone_number": "479-646-0706",
"fax_number": "479-646-0502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 OLD GREENWOOD RD",
"address_2": "SUITE 2",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729035929",
"telephone_number": "479-646-0706",
"fax_number": "479-646-0502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER",
"first_name": "BRADLEY",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-22",
"last_updated": "2008-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "3503",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "159196608",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.