Individual provider Active NPI

Robert H Lewis, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Rogers, AR
National Provider Identifier
1487765350
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
31 Issued in AR
Practice address
591 Horsebarn Rd
#100
Rogers, AR 72758-8780
Phone
(479) 636-3979
Fax
(479) 636-0800
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 31 AR Primary

Addresses

Primary practice location

591 Horsebarn Rd
#100
Rogers, AR 72758-8780

Mailing address

591 Horsebarn Rd
#100
Rogers, AR 72758-8780
Phone (479) 636-3979

Other identifiers 1

IdentifierTypeStateIssuer
5ZZ04OtherARBCBS MEDICAL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
31ARMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1487765350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 HORSEBARN RD",
            "address_2": "#100",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588780",
            "telephone_number": "479-636-3979",
            "fax_number": "479-636-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 HORSEBARN RD",
            "address_2": "#100",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588780",
            "telephone_number": "479-636-3979",
            "fax_number": "479-636-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ROBERT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AR",
            "license": "31",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MEDICAL",
            "identifier": "5ZZ04",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; 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.