NPIMap

Organization Active NPI

Bradley D Becker DDS PA

Doing business as River Valley Smile Center

  • General Practice Dentistry
  • Fort Smith, AR
National Provider Identifier
1285740878
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3503 Issued in AR
Legal business name
BRADLEY D BECKER DDS PA
Doing business as
River Valley Smile Center
Practice address
3600 Old Greenwood Rd
Ste 2
Fort Smith, AR 72903-5929
Phone
(479) 646-0706
Fax
(479) 646-0502
NPI assigned
Aug 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Bradley David Becker, DDSNPI 1215192000
Title
President
Phone
(479) 646-0706

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3503 AR Primary

Addresses

Primary practice location

3600 Old Greenwood Rd
Ste 2
Fort Smith, AR 72903-5929

Mailing address

3600 Old Greenwood Rd
Ste 2
Fort Smith, AR 72903-5929
Phone (479) 646-0706

Other identifiers 2

IdentifierTypeStateIssuer
1821165OtherARUNITED CONCORDIA
5Y750OtherARBCBS

Other names 1

  • River Valley Smile Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285740878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 OLD GREENWOOD RD",
            "address_2": "STE 2",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035929",
            "telephone_number": "479-646-0706",
            "fax_number": "479-646-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 OLD GREENWOOD RD",
            "address_2": "STE 2",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035929",
            "telephone_number": "479-646-0706",
            "fax_number": "479-646-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY D BECKER DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-646-0706",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1821165",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5Y750",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Valley Smile Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.