Icd Inc

Primary specialty

DentistTaxonomy code 122300000X

License

3573 Issued in AR

Legal business name

ICD INC

Doing business as

DeAtley Dental Care

Practice address

320 E 7TH St
Mountain Home, AR 72653-4416

Phone

(870) 425-1441

Fax

(870) 425-1445

NPI assigned

Apr 13, 2007

Organization subpart

Yes

Parent organization

ICD INC.As reported in NPPES

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

Authorized official

Name

Dr. Irvin Matthew Deatley, D.D.S.NPI 1164541348

Title

Owner

Phone

(870) 425-1441

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DeAtley Dental Care Doing business as

Part of

Icd Inc

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Irvin Matthew Deatley, D.D.S.

  • Dentist
  • Mountain Home, AR
  • NPI 1164541348
  NPD (past) Authorized official
• Christina Catherine Deatley, D.D.S.

  • Dentist
  • Mountain Home, AR
  • NPI 1316067473
  NPD (past)

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1306060850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E 7TH ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726534416",
            "telephone_number": "870-425-1441",
            "fax_number": "870-425-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E 7TH ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726534416",
            "telephone_number": "870-425-1441",
            "fax_number": "870-425-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICD INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ICD INC.",
        "enumeration_date": "2007-04-13",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "DEATLEY",
        "authorized_official_first_name": "IRVIN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-425-1441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AR",
            "license": "3573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161452631",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeAtley Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Hudson
• Bryson Huggins
• Melinda Humble, COTA
• Julie Kaylan Hutchens, APRN
• Cynthia Ann Hutchison, PHARM.D.,
• Inspirational Insight Counseling
• Interventional Pain Management Associates PLLC
• J Harley Barrow Jr MD PLLC (The Center for Women)
• Allen Charles Jackson, MD
• Kelsey Jackson, COTA

• Dentist in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.