Bob Mathis DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2029 Issued in AR

Legal business name

BOB MATHIS DDS PA

Practice address

26 Green Valley Dr
Bob Mathis DDS PA
Mountain Home, AR 72653-8102

Phone

(870) 425-6911

Fax

(870) 424-4891

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Bob Mathis, DDS

Title

President Dentist

Phone

(870) 425-6911

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437244589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 GREEN VALLEY DR",
            "address_2": "BOB MATHIS DDS PA",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726538102",
            "telephone_number": "870-425-6911",
            "fax_number": "870-424-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 GREEN VALLEY DR",
            "address_2": "BOB MATHIS DDS PA",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726538102",
            "telephone_number": "870-425-6911",
            "fax_number": "870-424-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOB MATHIS DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "PRESIDENT DENTIST",
        "authorized_official_telephone_number": "870-425-6911",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathaniel C Blanton, APRN
• Madison Bloodworth, OT-R
• Wendy Blount, RN
• Bmnrc, Inc. (Hiram Shaddox Geriatric Center)
• Bob E Cogburn MD PA
• Jodi Nicole Bodenhamer, APRN
• Asher G Bogdanove, PT
• Coleen Bohannon
• Paul Allen Bolt, OTR
• Amanda Nicole Bonham, L/COTA

• General Practice Dentistry in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.