Active NPI
Lendall Carroll Shell, DOS
- Dentist
- Benton, AR
National Provider Identifier
1306951397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2853
- Practice address
- 2101 C Congo Rd
Benton, AR 72015 - Phone
- (501) 778-1400
- Fax
- (501) 778-6194
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2853 | AR | Primary |
Addresses
Primary practice location
2101 C Congo Rd
Benton, AR 72015
Mailing address
2101 C Congo Rd
Benton, AR 72015
Phone (501) 778-1400
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Congo Dental, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306951397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 C CONGO RD",
"city": "BENTON",
"state": "AR",
"postal_code": "72015",
"telephone_number": "501-778-1400",
"fax_number": "501-778-6194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 C CONGO RD",
"city": "BENTON",
"state": "AR",
"postal_code": "72015",
"telephone_number": "501-778-1400",
"fax_number": "501-778-6194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELL",
"first_name": "LENDALL",
"middle_name": "CARROLL",
"name_prefix": "Dr.",
"credential": "DOS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "2853",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.