Active NPI
David Boyd Dean, MD
- Psychiatry Physician
- Fayetteville, AR
National Provider Identifier
1336217322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 17820
- Practice address
- 4153 N Crossover Rd
.Youth Bridge, Inc.
Fayetteville, AR 72703-4591 - Phone
- (479) 521-1532
- Fax
- (479) 521-1532
- NPI assigned
- Nov 30, 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 17820 | OK | Primary |
Addresses
Primary practice location
4153 N Crossover Rd
.Youth Bridge, Inc.
Fayetteville, AR 72703-4591
Mailing address
101 W University St
PO Box 160
Siloam Springs, AR 72761-2663
Phone (918) 326-4983
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14116 | Other | OK | OBNDD |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17820 | OK | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Workwell Industrial Medicine Clinic | Past | Accepting new patients | |
| Ozark Guidance Center, Inc | Past | Accepting new patients | |
| Youth Bridge | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Springdale, AR
- NPI 1659945194
-
- Occupational Medicine Physician
- Siloam Springs, AR
- NPI 1285755181
-
- Case Management Agency
- Centerton, AR
- NPI 1679961882
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1336217322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W UNIVERSITY ST",
"address_2": "PO BOX 160",
"city": "SILOAM SPRINGS",
"state": "AR",
"postal_code": "727612663",
"telephone_number": "918-326-4983",
"fax_number": "918-326-4983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4153 N CROSSOVER RD",
"address_2": ".YOUTH BRIDGE, INC.",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034591",
"telephone_number": "479-521-1532",
"fax_number": "479-521-1532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEAN",
"first_name": "DAVID",
"middle_name": "BOYD",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OK",
"license": "17820",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OBNDD",
"identifier": "14116",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.