NPIMap

Organization Active NPI

Austin Family Dentistry PA

  • Dentist
  • Maumelle, AR
National Provider Identifier
1255415956
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
AR3521 Issued in AR
Legal business name
AUSTIN FAMILY DENTISTRY PA
Practice address
3201 Club Manor
Suite a
Maumelle, AR 72113
Phone
(501) 851-3262
Fax
(501) 851-3766
NPI assigned
Oct 25, 2006
Last updated
May 6, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Authorized official

Name
Dr. Bryan A Austin, DDSNPI 1336306869
Title
Owner Pres
Phone
(501) 851-3262

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X AR3057 AR
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X AR3521 AR Primary

Addresses

Primary practice location

3201 Club Manor
Suite a
Maumelle, AR 72113

Mailing address

3201 Club Manor
Suite a
Maumelle, AR 72113
Phone (501) 851-3262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131021000617 AR DME Supplier - Oral Surgery - Dentist 9436384864 Practice locations: Maumelle, AR

National Provider Directory

National Provider Directory

Locations

3201 Club Manor Dr
Ste A
Maumelle, AR 72113
Phone (501) 851-3262

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367798400000",
    "number": "1255415956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 CLUB MANOR",
            "address_2": "SUITE A",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "72113",
            "telephone_number": "501-851-3262",
            "fax_number": "501-851-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 CLUB MANOR",
            "address_2": "SUITE A",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "72113",
            "telephone_number": "501-851-3262",
            "fax_number": "501-851-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN FAMILY DENTISTRY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2013-05-06",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER PRES",
        "authorized_official_telephone_number": "501-851-3262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AR",
            "license": "AR3057",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AR",
            "license": "AR3521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumelle, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.