Jacob Alan Sutton, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

3931 Issued in AR

Practice address

715 Eldridge Ave E
Wynne, AR 72396-4032

Phone

(870) 238-3628

Fax

(870) 238-0757

NPI assigned

Jun 17, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1487093019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 ELDRIDGE AVE E",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723964032",
            "telephone_number": "870-238-3628",
            "fax_number": "870-238-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 ELDRIDGE AVE E",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723964032",
            "telephone_number": "870-238-3628",
            "fax_number": "870-238-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "JACOB",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-17",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell Stricklin, D.D.S
• Paula Stroud
• Allisyn Stroupe
• Sushma C Parekh
• Hannah Rose Sutton, PA-C
• Callie Swaite, LPC
• Christa M Sykes
• Kimberly Beth Tackett, R.N.
• The Daring Space - a Private Therapy Practice (The Daring Space)
• The Ridge Vision Clinic PLLC

• Dentist in Wynne, AR
• Providers in Wynne, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.