River Valley Dental Group PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RIVER VALLEY DENTAL GROUP PLLC

Practice address

8309 Phoenix Avenue
Fort Smith, AR 72903

Phone

(479) 646-0706

Fax

(479) 646-0502

NPI assigned

Jul 5, 2012

Organization subpart

No

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

Authorized official

Name

Charles G Liggett Jr., DDS

Title

Partner/Owner

Phone

(479) 646-0706

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• River Valley Smile Center Doing business as

Locations

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1376808394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8309 PHOENIX AVENUE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72903",
            "telephone_number": "479-646-0706",
            "fax_number": "479-646-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8309 PHOENIX AVENUE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72903",
            "telephone_number": "479-646-0706",
            "fax_number": "479-646-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER VALLEY DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-05",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "LIGGETT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PARTNER/OWNER",
        "authorized_official_telephone_number": "479-646-0706",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159196608",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152884608",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20032200A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Valley Smile Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jamee Risley, MHPP
• Nohemy Rivas
• River Valley Anesthesia Associates, P. a.
• River Valley Back and Neck Clinic, Inc
• River Valley Community Center
• River Valley Gastroenterology, PLLC
• River Valley Mobile Dental Clinic
• River Valley Oral & Maxillofacial Surgery PLC
• River Valley Pediatric Dentistry PLLC
• River Valley Pediatrics LLC

• General Practice Dentistry in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.