Individual provider Active NPI

Mitchell Lynn Collins, D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Conway, AR
National Provider Identifier
1407825656
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
3079 Issued in AR
Practice address
525 Western Ave
Suite 204
Conway, AR 72034-4967
Phone
(501) 336-8888
Fax
(501) 336-8887
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3079 AR Primary

Addresses

Primary practice location

525 Western Ave
Suite 204
Conway, AR 72034-4967

Mailing address

525 Western Ave
Suite 204
Conway, AR 72034-4967
Phone (501) 336-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jun 3, 2016 through Jun 3, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3079ARMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Maxillofacial Surgery Center of Central Arkansas Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 1

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407825656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 WESTERN AVE",
            "address_2": "SUITE 204",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344967",
            "telephone_number": "501-336-8888",
            "fax_number": "501-336-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 WESTERN AVE",
            "address_2": "SUITE 204",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344967",
            "telephone_number": "501-336-8888",
            "fax_number": "501-336-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "MITCHELL",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AR",
            "license": "3079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.