Individual provider Active NPI

John Michael Burrows, D.D.S.

  • Pediatric Dentistry
  • Marion, AR
National Provider Identifier
1225211196
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
3647 Issued in AR
Practice address
303 Bancario
Ste 11-12
Marion, AR 72364-2825
Phone
(870) 739-2992
Fax
(870) 739-8597
NPI assigned
Dec 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DS7983 TN
Pediatric Dentistry 1223P0221X 3647 AR Primary

Addresses

Primary practice location

303 Bancario
Ste 11-12
Marion, AR 72364-2825

Mailing address

303 Bancario
Ste 11-12
Marion, AR 72364-2825
Phone (870) 739-2992

Other practice location 1

646 E Main St Ste B
Blytheville, AR 72315-2125
Phone (870) 824-6677

Other practice location 2

316 W Tyler Ave
West Memphis, AR 72301-4225
Phone (870) 735-5439

Other identifiers 1

IdentifierTypeStateIssuer
168709608MedicaidAR

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

LicenseStateTypeSpecialty
3647ARMDPediatric Dentist
DS7983TNMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Pediatric Dentistry, PLLC CurrentSince Sep 1, 2024 Accepting new patients
West Memphis Pediatric Dentistry Past Accepting new patients
Blytheville Pediatric Dentistry, PLLC Past Accepting new patients

Locations

646 E Main St
Ste B
Blytheville, AR 72315
Phone (870) 824-6677

303 Bancario
Ste 1112
Marion, AR 72364
Phone (870) 739-2992

316 W Tyler Ave
West Memphis, AR 72301
Phone (870) 732-8200

Organizations & group practices 3

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": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1225211196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 BANCARIO",
            "address_2": "STE 11-12",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642825",
            "telephone_number": "870-739-2992",
            "fax_number": "870-739-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 BANCARIO",
            "address_2": "STE 11-12",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642825",
            "telephone_number": "870-739-2992",
            "fax_number": "870-739-8597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "646 E Main St Ste B",
            "address_purpose": "LOCATION",
            "city": "Blytheville",
            "state": "AR",
            "postal_code": "723152125",
            "country_code": "US",
            "telephone_number": "870-824-6677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "316 W Tyler Ave",
            "address_purpose": "LOCATION",
            "city": "West Memphis",
            "state": "AR",
            "postal_code": "723014225",
            "country_code": "US",
            "telephone_number": "870-735-5439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURROWS",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-13",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "DS7983",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AR",
            "license": "3647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168709608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.