Active NPI
Robert Lester Barrett, DDS
- Pediatric Dentistry
- Bald Knob, AR
National Provider Identifier
1417002106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 2146 (17)
- Practice address
- 2802 Highway 367 N
Bald Knob, AR 72010-3165 - Phone
- (870) 724-6207
- Fax
- (870) 347-3492
- NPI assigned
- Jan 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 2146 (17) | AR | Primary |
| Dentist | 122300000X | 2146 | AR |
Addresses
Primary practice location
2802 Highway 367 N
Bald Knob, AR 72010-3165
Mailing address
PO Box 497
Augusta, AR 72006-0497
Phone (870) 347-2534
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101731608 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2146 | AR | MD | Dentist |
| 2146 (17) | AR | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317772800000",
"number": "1417002106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 497",
"city": "AUGUSTA",
"state": "AR",
"postal_code": "720060497",
"telephone_number": "870-347-2534",
"fax_number": "870-347-3492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2802 HIGHWAY 367 N",
"city": "BALD KNOB",
"state": "AR",
"postal_code": "720103165",
"telephone_number": "870-724-6207",
"fax_number": "870-347-3492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARRETT",
"first_name": "ROBERT",
"middle_name": "LESTER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-24",
"last_updated": "2011-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "AR",
"license": "2146 (17)",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "2146",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101731608",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bald Knob, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.