Individual provider Active NPI

McKenzie Suzanne Smith Carr, DDS

  • Dentist
  • Benton, AR
National Provider Identifier
1275494395
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4894 Issued in AR
Practice address
818 W South St
Benton, AR 72015-4162
Phone
(501) 776-0564
NPI assigned
Nov 19, 2025
Last updated
Nov 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4894 AR Primary

Addresses

Primary practice location

818 W South St
Benton, AR 72015-4162

Mailing address

818 W South St
Benton, AR 72015-4162
Phone (501) 776-0564

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
4894ARMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jolly Dental-Benton, P.a. CurrentSince Nov 24, 2025 Accepting new patients
Robert R. Carlisle, D.D.S. PastSince Nov 24, 2025 Accepting new patients

Locations

818 W South St
Benton, AR 72015
Phone (501) 776-0564

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1763510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1275494395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 W SOUTH ST",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720154162",
            "telephone_number": "501-776-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 W SOUTH ST",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720154162",
            "telephone_number": "501-776-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "MCKENZIE",
        "middle_name": "SUZANNE SMITH",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-19",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "4894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; 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.