Active NPI
Ronald Glenn Roberts, DDS
- General Practice Dentistry
- Huntsville, AR
National Provider Identifier
1366543779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1943
- Practice address
- 409 Church Avenue
Huntsville, AR 72740 - Phone
- (479) 738-2777
- Fax
- (479) 738-2705
- NPI assigned
- Sep 26, 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1943 | AR | Primary |
Addresses
Primary practice location
409 Church Avenue
Huntsville, AR 72740
Mailing address
PO Box 249
409 Church Avenue
Huntsville, AR 72740
Phone (479) 738-2777
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1943 | AR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ronald G. Roberts, D.D.S. | General Practice | 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.
-
- General Practice Dentistry
- Huntsville, AR
- NPI 1518103787
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366543779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 249",
"address_2": "409 CHURCH AVENUE",
"city": "HUNTSVILLE",
"state": "AR",
"postal_code": "72740",
"telephone_number": "479-738-2777",
"fax_number": "479-738-2705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 CHURCH AVENUE",
"city": "HUNTSVILLE",
"state": "AR",
"postal_code": "72740",
"telephone_number": "479-738-2777",
"fax_number": "479-738-2705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "RONALD",
"middle_name": "GLENN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "1943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntsville, 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.