Brandon Ray Stroope, D.M.D.
Individual provider Active NPI Dentist · Siloam Springs, AR
NPI 1265729644 · NPPES record last updated Nov 8, 2021
Key facts
- NPI
- 1265729644
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 3825 (AR)
- Practice address
- 3860 Highway 412 E Ste F
Siloam Springs, AR 72761 - Phone
- (479) 306-6433
- Fax
- (479) 524-0976
- NPI assigned
- Jul 6, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150731016486 | CA | Order and Referring Only - Dentist |
8527372721 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3825 | AR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brandon R Stroope. DMD. PLLC | Dentist | Current | Accepting new patients |
Locations
3860 Highway 412 E
Ste F
Siloam Springs, AR 72761
Phone (479) 306-6433
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3825 | AR | Yes |
Addresses
Primary practice location
3860 Highway 412 E Ste F
Siloam Springs, AR 72761
Mailing address
3860 Highway 412 E Ste F
Siloam Springs, AR 72761-8499
Phone (479) 306-6433
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 191410608 | Medicaid | AR |
Other providers in Siloam Springs, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.