Individual provider Active NPI

Rodney Alan Griffin, DDS

  • General Practice Dentistry
  • Batesville, AR
National Provider Identifier
1255415097
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3337 Issued in AR
Practice address
311 Eagle MTN Blvd
Batesville, AR 72501
Phone
(870) 698-2160
Fax
(870) 698-8956
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3337 AR Primary

Addresses

Primary practice location

311 Eagle MTN Blvd
Batesville, AR 72501

Mailing address

311 Eagle MTN Blvd
Batesville, AR 72501
Phone (870) 698-2160

Other identifiers 3

IdentifierTypeStateIssuer
140236608MedicaidAR
618998OtherARUNITED CONCORDIA
5U836OtherARAR BLUE CROSS BLUE SHIELD

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
3337ARMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley S Griffin, DDS PastSince Feb 7, 2021 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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1255415097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 EAGLE MTN BLVD",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "72501",
            "telephone_number": "870-698-2160",
            "fax_number": "870-698-8956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 EAGLE MTN BLVD",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "72501",
            "telephone_number": "870-698-2160",
            "fax_number": "870-698-8956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "RODNEY",
        "middle_name": "ALAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140236608",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "618998",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BLUE CROSS BLUE SHIELD",
            "identifier": "5U836",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.