Individual provider Active NPI

Roy L Bratton, DDS

  • General Practice Dentistry
  • Atkins, AR
National Provider Identifier
1477655561
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2780 Issued in AR
Practice address
406 N Church St
Atkins, AR 72823-4149
Phone
(479) 641-4081
Fax
(479) 641-7705
NPI assigned
Sep 1, 2006
Last updated
Mar 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2780 AR Primary

Addresses

Primary practice location

406 N Church St
Atkins, AR 72823-4149

Mailing address

406 N Church St
P.O. Box 406
Atkins, AR 72823-4149
Phone (479) 641-4081

Other practice location 1

2320 Fayetteville Rd
Van Buren, AR 72956-6511
Phone (479) 632-6110

Other identifiers 1

IdentifierTypeStateIssuer
114113608MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220905000297 AR Practitioner - Dentist 6204139397 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2780ARMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
R K Girlinghouse DDS PA General Practice CurrentSince Jun 22, 2022 Accepting new patients
R K Girlinghouse DDS PA General Practice CurrentSince Jun 22, 2022 Accepting new patients
Atkins Dental Clinic PC General Practice Past Accepting new patients

Locations

2307 S Zero St
Ste 103
Fort Smith, AR 72901
Phone (479) 646-4499

2308 Fayetteville Rd
Ste 1600
Van Buren, AR 72956
Phone (479) 474-7600

Organizations & group practices 3

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1477655561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 N CHURCH ST",
            "address_2": "P.O. BOX 406",
            "city": "ATKINS",
            "state": "AR",
            "postal_code": "728234149",
            "telephone_number": "479-641-4081",
            "fax_number": "479-641-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N CHURCH ST",
            "city": "ATKINS",
            "state": "AR",
            "postal_code": "728234149",
            "telephone_number": "479-641-4081",
            "fax_number": "479-641-7705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2320 Fayetteville Rd",
            "address_purpose": "LOCATION",
            "city": "Van Buren",
            "state": "AR",
            "postal_code": "729566511",
            "country_code": "US",
            "telephone_number": "479-632-6110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRATTON",
        "first_name": "ROY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114113608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atkins, AR

Sources for this page

Verify at the official NPI Registry.