NPIMap

Organization Active NPI

Southern Dental of Jonesboro, PLLC

  • General Practice Dentistry
  • Jonesboro, AR
National Provider Identifier
1376904953
Registry record updated Mar 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3930 Issued in AR
Legal business name
SOUTHERN DENTAL OF JONESBORO, PLLC
Practice address
2500 Browns LN Ste a
Jonesboro, AR 72401-6107
Phone
(870) 243-4406
NPI assigned
Mar 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2016

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

Authorized official

Name
Dr. William Reynolds Little, D.D.S.
Title
Member
Phone
(870) 243-4406

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3930 AR Primary

Addresses

Primary practice location

2500 Browns LN Ste a
Jonesboro, AR 72401-6107

Mailing address

2500 Browns LN Ste a
Jonesboro, AR 72401-6107
Phone (870) 243-4406

National Provider Directory

National Provider Directory

Locations

2500 Browns Ln
#A
Jonesboro, AR 72401
Phone (870) 243-4406

NPI Registry JSON

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

{
    "created_epoch": "1457568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457568000000",
    "number": "1376904953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 BROWNS LN STE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016107",
            "telephone_number": "870-243-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 BROWNS LN STE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016107",
            "telephone_number": "870-243-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DENTAL OF JONESBORO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-10",
        "last_updated": "2016-03-10",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "REYNOLDS",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "870-243-4406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2016; 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.