NPIMap

Organization Active NPI

Higginbotham Dental Group, PLLC

  • General Practice Dentistry
  • Kennett, MO
National Provider Identifier
1366797953
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HIGGINBOTHAM DENTAL GROUP, PLLC
Doing business as
Doing Business As
Practice address
103 1St St
Kennett, MO 63857-2051
Phone
(573) 888-9944
Fax
(573) 888-9789
NPI assigned
Jul 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Authorized official

Name
Misti Ross
Title
Ins Director
Phone
(870) 336-3732

Specialties & licenses 1

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

Addresses

Primary practice location

103 1St St
Kennett, MO 63857-2051

Mailing address

1804 Old Greensboro Rd BLDG B
Jonesboro, AR 72405-0003
Phone (870) 336-3732

Other names 1

  • Doing Business As Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Higginbotham Dental Group PLLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

103 1st St
Kennett, MO 63857
Phone (573) 888-9944

NPI Registry JSON

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602633600000",
    "number": "1366797953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 OLD GREENSBORO RD BLDG B",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724050003",
            "telephone_number": "870-336-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 1ST ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638572051",
            "telephone_number": "573-888-9944",
            "fax_number": "573-888-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGGINBOTHAM DENTAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-19",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "MISTI",
        "authorized_official_title_or_position": "INS DIRECTOR",
        "authorized_official_telephone_number": "870-336-3732"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doing Business As",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennett, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.