NPIMap

Organization Active NPI

Marks Children's Dentistry

Doing business as Saline County Children's Dentistry

  • Pediatric Dentistry
  • Bryant, AR
National Provider Identifier
1366639585
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
3619 Issued in AR
Legal business name
MARKS CHILDREN'S DENTISTRY
Doing business as
Saline County Children's Dentistry
Practice address
3310 Hwy 5 N
Bryant, AR 72019-9031
Phone
(501) 847-7070
NPI assigned
Oct 2, 2007
Last updated
Jun 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Authorized official

Name
Dr. Derek Thomas Marks, D.D.S.NPI 1033318068
Title
Owner Operator
Phone
(501) 847-7070

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
Pediatric Dentistry 1223P0221X 3619 AR Primary

Addresses

Primary practice location

3310 Hwy 5 N
Bryant, AR 72019-9031

Mailing address

3310 Hwy 5 North
Bryant, AR 72019-7552
Phone (501) 847-7070

Other identifiers 2

IdentifierTypeStateIssuer
164860608MedicaidAR
164914631MedicaidAR

Other names 1

  • Saline County Children's Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

3310 Highway 5 N
Bryant, AR 72019
Phone (501) 847-7070

Practitioners & affiliated clinicians

Practitioners 6

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": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1366639585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 HWY 5 NORTH",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720197552",
            "telephone_number": "501-847-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 HWY 5 N",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720199031",
            "telephone_number": "501-847-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARKS CHILDREN'S DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "501-847-7070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AR",
            "license": "3619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164860608",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164914631",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saline County Children's Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bryant, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.