Douglas Alan Griffin, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3003 Issued in AR

Practice address

200 N Phoenix Ave
Russellville, AR 72801-2826

Phone

(479) 968-1655

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dr. Douglas a. Griffin D.D.S., P.a.

  • General Practice Dentistry
  • Russellville, AR
  • NPI 1326121146
  NPD (past) Authorized official

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366525172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N PHOENIX AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012826",
            "telephone_number": "479-968-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N PHOENIX AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012826",
            "telephone_number": "479-968-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "DOUGLAS",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Green, LAC
• Kari Green, MHPP
• Lauren Green
• Taylee Gregg
• Brooke Grice, LAC
• Charity Grisham, PHARMD
• Mateo Guarderas Ribadeneira, M.D.
• Daryl Guffey
• Sarah Alain Gumm
• Michael W Gund, CRNA

• General Practice Dentistry in Russellville, AR
• Providers in Russellville, AR by specialty
• General Practice Dentistry in Arkansas

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.