Organization Active NPI

Roy R Jolley DDS

  • Dental Clinic/Center
  • Little Rock, AR
National Provider Identifier
1386934016
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
1981 Issued in AR
Legal business name
ROY R JOLLEY DDS
Practice address
5 Van Cir
Little Rock, AR 72207-5211
Phone
(501) 664-5615
Fax
(501) 664-9118
NPI assigned
Apr 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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

Authorized official

Name
Dr. Roy Jolley, D.D.S.NPI 1568506723
Title
President
Phone
(501) 664-5615

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 1981 AR Primary

Addresses

Primary practice location

5 Van Cir
Little Rock, AR 72207-5211

Mailing address

5 Van Cir
Little Rock, AR 72207-5211
Phone (501) 664-5615

Other identifiers 1

IdentifierTypeStateIssuer
110054631MedicaidAR

National Provider Directory

National Provider Directory

Locations

5 Van Cir
Little Rock, AR 72207
Phone (501) 664-5615

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302739200000",
    "number": "1386934016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 VAN CIR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722075211",
            "telephone_number": "501-664-5615",
            "fax_number": "501-664-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 VAN CIR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722075211",
            "telephone_number": "501-664-5615",
            "fax_number": "501-664-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROY R JOLLEY DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-14",
        "last_updated": "2011-04-14",
        "status": "A",
        "authorized_official_last_name": "JOLLEY",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-664-5615",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AR",
            "license": "1981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110054631",
            "state": "AR"
        }
    ],
    "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 Apr 14, 2011; 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.