Dustin Donald Kenny, DDS
Individual provider Active NPI Dentist · Fort Smith, AR
NPI 1225820632 · NPPES record last updated May 21, 2025
Key facts
- NPI
- 1225820632
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 4840 (AR)
- Practice address
- 7801 Phoenix Ave
Fort Smith, AR 72903-5091 - Phone
- (479) 306-6156
- NPI assigned
- May 21, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4840 | AR | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4840 | AR | Yes |
Addresses
Primary practice location
7801 Phoenix Ave
Fort Smith, AR 72903-5091
Mailing address
805 S 3Rd St
Rogers, AR 72756-4620
Phone (479) 640-3308
Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.