Carl Norvin Overcash, DDS
Individual provider Active NPI General Practice Dentistry · Brinkley, AR
NPI 1386726362 · NPPES record last updated Nov 18, 2020
Key facts
- NPI
- 1386726362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2584 (AR)
- Practice address
- 105 S Main Ave
Brinkley, AR 72021 - Phone
- (870) 734-4722
- Fax
- (870) 734-3236
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151228000623 | AR | Order and Referring Only - Oral Surgery |
4486955069 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2584 | AR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carl N Overcash | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2584 | AR | Yes |
Addresses
Primary practice location
105 S Main Ave
Brinkley, AR 72021
Mailing address
105 S Main Ave
Brinkley, AR 72021
Phone (870) 734-4722
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103570608 | Medicaid | AR |
Other providers in Brinkley, AR
- Medi-Mart Pharmacy Inc
- Monroe County Human Development Center, Inc.
- Andrew Neaville
- Northeast Arkansas Community Mental Health Center Inc
- Odyssey Healthcare Operating a, LP
- Colby Petty
- Dac Tat Pham
- Michael Sayger
- Simmons Eye Center
- Johnathan Clyde Simpson
All providers in Brinkley, AR · General Practice Dentistry in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.