NPIMap

Organization Active NPI

Kavanaugh Dental

  • General Practice Dentistry
  • Little Rock, AR
National Provider Identifier
1366879249
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2807 Issued in AR
Legal business name
KAVANAUGH DENTAL
Practice address
5307 Kavanaugh Blvd
Little Rock, AR 72207-4610
Phone
(501) 666-2801
Fax
(501) 666-4863
NPI assigned
Oct 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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

Authorized official

Name
Patrick Kircher
Title
Owner
Phone
(501) 666-2801

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 2807 AR Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 3929 AR

Addresses

Primary practice location

5307 Kavanaugh Blvd
Little Rock, AR 72207-4610

Mailing address

5307 Kavanaugh Blvd
Little Rock, AR 72207-4610
Phone (501) 666-2801

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1366879249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5307 KAVANAUGH BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722074610",
            "telephone_number": "501-666-2801",
            "fax_number": "501-666-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5307 KAVANAUGH BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722074610",
            "telephone_number": "501-666-2801",
            "fax_number": "501-666-4863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAVANAUGH DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-09",
        "last_updated": "2013-10-09",
        "status": "A",
        "authorized_official_last_name": "KIRCHER",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-666-2801"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2807",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3929",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.