NPIMap

Organization Active NPI

Wayne Cook Dentisrty LLC

  • Dental Clinic/Center
  • Marion, AR
National Provider Identifier
1457716870
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
3113 Issued in AR
Legal business name
WAYNE COOK DENTISRTY LLC
Practice address
303 Bancario Ste 7
Marion, AR 72364-2826
Phone
(870) 739-8799
Fax
(870) 739-8675
NPI assigned
Dec 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Authorized official

Name
Dr. Jerry Wayne Cook Jr., D.D.S.NPI 1306935788
Title
Owner
Phone
(870) 739-8799

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 3113 AR Primary

Addresses

Primary practice location

303 Bancario Ste 7
Marion, AR 72364-2826

Mailing address

303 Bancario Ste 7
Marion, AR 72364-2826
Phone (870) 739-8799

Other identifiers 1

IdentifierTypeStateIssuer
128223608MedicaidAR

National Provider Directory

National Provider Directory

Locations

303 Bancario
Ste 7
Marion, AR 72364
Phone (870) 739-8799

Practitioners & affiliated clinicians

Practitioners 1

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": "1451433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451433600000",
    "number": "1457716870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 BANCARIO STE 7",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642826",
            "telephone_number": "870-739-8799",
            "fax_number": "870-739-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 BANCARIO STE 7",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642826",
            "telephone_number": "870-739-8799",
            "fax_number": "870-739-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE COOK DENTISRTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-30",
        "last_updated": "2015-12-30",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-739-8799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AR",
            "license": "3113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128223608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.