NPIMap

Organization Active NPI

River Dental Farmington, PLLC

  • General Practice Dentistry
  • Farmington, AR
National Provider Identifier
1447792759
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
RIVER DENTAL FARMINGTON, PLLC
Practice address
82 Southwinds Rd
Farmington, AR 72730-8677
Phone
(479) 267-2266
Fax
(479) 267-4480
NPI assigned
Nov 17, 2016
Last updated
Oct 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Authorized official

Name
Anne Joelle Demmy
Title
Credentialing Specialist
Phone
(918) 998-0996

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

82 Southwinds Rd
Farmington, AR 72730-8677

Mailing address

400 Riverwalk Ter Ste 250
Jenks, OK 74037-5619
Phone (918) 998-0996

National Provider Directory

National Provider Directory

Locations

19 W Main St
Farmington, AR 72730
Phone (479) 267-2266

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1447792759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERWALK TER STE 250",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375619",
            "telephone_number": "918-998-0996",
            "fax_number": "918-235-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 SOUTHWINDS RD",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727308677",
            "telephone_number": "479-267-2266",
            "fax_number": "479-267-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER DENTAL FARMINGTON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-17",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "DEMMY",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "JOELLE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "918-998-0996"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.