NPIMap

Organization Active NPI

Bethel Burris Oliver PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Bentonville, AR
National Provider Identifier
1225409170
Registry record updated Oct 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
BETHEL BURRIS OLIVER PLLC
Practice address
3000 Medical Center Pkwy
Bentonville, AR 72712-3217
Phone
(479) 445-6335
Fax
(479) 301-2878
NPI assigned
Oct 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2015

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

Authorized official

Name
Benjamin Burris, DDS, MDS
Title
Owner
Phone
(479) 445-6335

Specialties & licenses 1

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

Addresses

Primary practice location

3000 Medical Center Pkwy
Bentonville, AR 72712-3217

Mailing address

4375 N Vantage Dr
Suite 202
Fayetteville, AR 72703-4982
Phone (479) 445-6335

Other names 1

  • Arkansas Dentistry and Braces Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Arkansas Dentistry and Braces22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1225409170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 N VANTAGE DR",
            "address_2": "SUITE 202",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034982",
            "telephone_number": "479-445-6335",
            "fax_number": "479-301-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MEDICAL CENTER PKWY",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123217",
            "telephone_number": "479-445-6335",
            "fax_number": "479-301-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL BURRIS OLIVER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-16",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "BURRIS",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-445-6335",
        "authorized_official_credential": "DDS, MDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arkansas Dentistry and Braces",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.