Active NPI
Jordan Tyler Hillis, DDS
- Dentist
- Ashdown, AR
National Provider Identifier
1467612465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3665
- Practice address
- 96 Webster Dr
Ashdown, AR 71822-9103 - Phone
- (870) 898-8888
- Fax
- (870) 898-4650
- NPI assigned
- Jun 12, 2008
- Last updated
- Aug 28, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3665 | AR | Primary |
Addresses
Primary practice location
96 Webster Dr
Ashdown, AR 71822-9103
Mailing address
96 Webster Dr
Ashdown, AR 71822-9103
Phone (870) 898-8888
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 |
|---|---|---|---|
| 3665 | AR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jordan Hillis D.D.S. PA | Dentist | Current | Accepting new patients |
Locations
96 Webster Dr
Ashdown, AR 71822
Phone (870) 898-8888
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566950400000",
"number": "1467612465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "96 WEBSTER DR",
"city": "ASHDOWN",
"state": "AR",
"postal_code": "718229103",
"telephone_number": "870-898-8888",
"fax_number": "870-898-4650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 WEBSTER DR",
"city": "ASHDOWN",
"state": "AR",
"postal_code": "718229103",
"telephone_number": "870-898-8888",
"fax_number": "870-898-4650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILLIS",
"first_name": "JORDAN",
"middle_name": "TYLER",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-12",
"last_updated": "2019-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "3665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ashdown, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.