NPIMap

Organization Active NPI

Kemp Childs, DDS, PA

  • General Practice Dentistry
  • Trumann, AR
National Provider Identifier
1356417406
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2610 Issued in AR
Legal business name
KEMP CHILDS, DDS, PA
Practice address
143 Hwy 463 North
Trumann, AR 72472
Phone
(870) 483-7654
Fax
(870) 483-7047
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Charles K Childs Jr., DDSNPI 1821103078
Title
Owner
Phone
(870) 483-7654

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2610 AR Primary

Addresses

Primary practice location

143 Hwy 463 North
Trumann, AR 72472

Mailing address

143 Hwy 463 North
Trumann, AR 72472
Phone (870) 483-7654

Other identifiers 2

IdentifierTypeStateIssuer
58751OtherARBLUECROSS BLUESHIELD, ID#
595995OtherUNITED CONCORDIA ID #

National Provider Directory

National Provider Directory

Locations

143 Highway 463 N
Trumann, AR 72472
Phone (870) 483-7654

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356417406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 HWY 463 NORTH",
            "city": "TRUMANN",
            "state": "AR",
            "postal_code": "72472",
            "telephone_number": "870-483-7654",
            "fax_number": "870-483-7047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 HWY 463 NORTH",
            "city": "TRUMANN",
            "state": "AR",
            "postal_code": "72472",
            "telephone_number": "870-483-7654",
            "fax_number": "870-483-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEMP CHILDS, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHILDS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-483-7654",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD, ID#",
            "identifier": "58751",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA ID #",
            "identifier": "595995",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumann, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.