Active NPI
Aixa Jolley
- General Practice Dentistry
- Rogers, AR
National Provider Identifier
1275377822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4765
- Practice address
- 2001 W Walnut St
Rogers, AR 72756-3243 - Phone
- (479) 636-6807
- NPI assigned
- Jun 19, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 4765 | AR | Primary |
Addresses
Primary practice location
2001 W Walnut St
Rogers, AR 72756-3243
Mailing address
5381 Little Field Ave
Springdale, AR 72762-3244
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4765 | AR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| River Dental Rogers, PLLC | Current | Accepting new patients | |
| Medical Anesthesia Services, LLC | Past | Accepting new patients |
Locations
2001 W Walnut St
Rogers, AR 72756
Phone (479) 636-6807
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Rogers, AR
- NPI 1891273835
-
- Certified Registered Nurse Anesthetist
- Fayetteville, AR
- NPI 1598221616
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721433600000",
"number": "1275377822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5381 LITTLE FIELD AVE",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "727623244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 W WALNUT ST",
"city": "ROGERS",
"state": "AR",
"postal_code": "727563243",
"telephone_number": "479-636-6807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLLEY",
"first_name": "AIXA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-19",
"last_updated": "2024-07-20",
"certification_date": "2024-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "4765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.