NPIMap

Organization Active NPI

Ar Periodontal & Implant Assoc

  • Dentist
  • Harrison, AR
National Provider Identifier
1346643699
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3262 Issued in AR
Legal business name
AR PERIODONTAL & IMPLANT ASSOC
Practice address
1405 McCoy Dr
Harrison, AR 72601-2417
Phone
(479) 521-6400
Fax
(479) 521-0164
NPI assigned
Oct 1, 2014
Last updated
Oct 9, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
AR PERIODONTAL & IMPLANT ASSOCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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

Authorized official

Name
Mrs. Cindy Kay Raben
Title
Office Manager
Phone
(479) 521-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3262 AR Primary

Addresses

Primary practice location

1405 McCoy Dr
Harrison, AR 72601-2417

Mailing address

2001 N Green Acres Rd
Fayetteville, AR 72703-2619
Phone (479) 521-6400

National Provider Directory

National Provider Directory
Tax ID family
Northwest Arkansas Periodontal Associates PLLC3 organizations share this tax ID, including this one
Part of
Northwest Arkansas Periodontal Associates PLLC

Other organizations with this tax ID 2

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

Locations

2001 N Green Acres Rd
Fayetteville, AR 72703
Phone (479) 521-6365

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": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412812800000",
    "number": "1346643699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N GREEN ACRES RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032619",
            "telephone_number": "479-521-6400",
            "fax_number": "479-521-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MCCOY DR",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012417",
            "telephone_number": "479-521-6400",
            "fax_number": "479-521-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AR PERIODONTAL & IMPLANT ASSOC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AR PERIODONTAL & IMPLANT ASSOC",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-09",
        "status": "A",
        "authorized_official_last_name": "RABEN",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "479-521-6400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; 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.