Individual provider Active NPI

Kevin Huy Dang, O.D.

  • Optometrist
  • Fort Smith, AR
National Provider Identifier
1376503169
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2498 Issued in AR
Practice address
4189 Phoenix Ave
Fort Smith, AR 72903-6013
Phone
(479) 434-4668
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2498 AR Primary

Addresses

Primary practice location

4189 Phoenix Ave
Fort Smith, AR 72903-6013

Mailing address

4189 Phoenix Ave Ste B
Fort Smith, AR 72903-6013
Phone (479) 434-4668

Other identifiers 1

IdentifierTypeStateIssuer
143673722MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090402000544 AR Practitioner - Optometry 6103973458 Reassigns benefits to 1 organization
I20220315002283 OK Practitioner - Optometry 6103973458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dang Eyecare and Associates, P.a.Group PAC ID 2365599610, 11 clinicians

Practice addresses (Care Compare)

4189 Phoenix Ave
Fort Smith, AR 72903-6013

7199 SE 29TH St
Suite 110
Midwest City, OK 73110-6004
Phone (405) 737-6681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2498ARMDOptometrist
2772OKMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dang Eyecare & Associates, P.a. Optometrist CurrentSince Aug 9, 1999 Accepting new patients
Jones Eyecare Associates PC Optometrist Past Accepting new patients

Locations

745 E Joyce Blvd
Ste 124
Fayetteville, AR 72703
Phone (479) 582-1366

4189 Phoenix Ave
Ste B
Fort Smith, AR 72903
Phone (479) 434-4668

4189 Phoenix Ave
Fort Smith, AR 72903
Phone (479) 434-3680

2600 W Pleasant Crossing Dr
Ste 60
Rogers, AR 72758
Phone (479) 202-4725

7199 SE 29th St
Ste 110
Midwest City, OK 73110
Phone (405) 737-6681

7199 SE 29th St
Ste 110B
Midwest City, OK 73110
Phone (405) 737-6681

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1376503169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4189 PHOENIX AVE STE B",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729036013",
            "telephone_number": "479-434-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4189 PHOENIX AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729036013",
            "telephone_number": "479-434-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANG",
        "first_name": "KEVIN",
        "middle_name": "HUY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143673722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.