Austin Family Dentistry PA

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

Organization subpart

No

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

Authorized official

Name

Dr. Bryan A Austin, DDS

Title

Owner Pres

Phone

(501) 851-3262

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

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.

• Austin Family Dentisty of Little Rock

  • Dentist
  • Little Rock, AR
  • NPI 1588087993
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Simona Ivan, D.D.S

  • General Practice Dentistry
  • Maumelle, AR
  • NPI 1811329329
  NPD (past)

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCCI DR CLINT FULKS",
            "identifier": "1871870",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCCI DR BRYAN A AUSTIN",
            "identifier": "828326",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "58662",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arkansas Health PLLC
• Arkansas Reliable Transportation LLC
• David Arnold
• Mary Helen Ashley, M.S. CCC-SLP
• Omar Atassi
• Bryan A Austin, D.D.S.
• Jalesia Austin, APRN
• Balentine Medical Services, PLLC
• BCC Maumelle Operations, LLC
• Amy Lynn Beard, M.D.

• Dentist in Maumelle, AR
• Providers in Maumelle, AR by specialty
• Dentist in Arkansas

• 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.