NPIMap

Organization Active NPI

Dental Health Associates of Arkansas, P.a.

Doing business as Russellville Dental Group

  • General Practice Dentistry
  • Russellville, AR
National Provider Identifier
1295155158
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL HEALTH ASSOCIATES OF ARKANSAS, P.A.
Doing business as
Russellville Dental Group
Practice address
230 N Elmira Ave
Russellville, AR 72802-9617
Phone
(479) 280-1920
NPI assigned
Apr 18, 2014
Organization subpart
Yes
Parent organization
DENTAL HEALTH ASSOCIATES OF ARKANSAS, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Authorized official

Name
Hannah Fish
Title
Credentialing Manager
Phone
(217) 540-5699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

230 N Elmira Ave
Russellville, AR 72802-9617

Mailing address

230 N Elmira Ave
Russellville, AR 72802-9617

Other names 1

  • Russellville Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dr Johnny Pearce7 organizations share this tax ID, including this one
Part of
Dr Johnny Pearce

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

230 N Elmira Ave
Russellville, AR 72802
Phone (479) 213-1790

Practitioners & affiliated clinicians

Practitioners 3

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": "1397779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1295155158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N ELMIRA AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728029617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N ELMIRA AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728029617",
            "telephone_number": "479-280-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEALTH ASSOCIATES OF ARKANSAS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL HEALTH ASSOCIATES OF ARKANSAS, P.A.",
        "enumeration_date": "2014-04-18",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "FISH",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "217-540-5699"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Russellville Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Russellville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.