Individual provider Active NPI

Christopher Clayton Loftin, D.D.S.

  • Dentist
  • Booneville, AR
National Provider Identifier
1487934543
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6290 Issued in OK
Practice address
1057 W Main St
Booneville, AR 72927-3403
Phone
(479) 675-3251
NPI assigned
Aug 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6290 OK Primary

Addresses

Primary practice location

1057 W Main St
Booneville, AR 72927-3403

Mailing address

1057 W Main St
Booneville, AR 72927-3403
Phone (479) 675-3521

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
I20200619000218 AR Order and Referring Only - DentistPractitioner - Dentist 5496177545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6290OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Loftin Dental, PLLC Current Accepting new patients

Locations

1057 W Main St
Booneville, AR 72927
Phone (479) 675-3251

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1487934543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 W MAIN ST",
            "city": "BOONEVILLE",
            "state": "AR",
            "postal_code": "729273403",
            "telephone_number": "479-675-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 W MAIN ST",
            "city": "BOONEVILLE",
            "state": "AR",
            "postal_code": "729273403",
            "telephone_number": "479-675-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOFTIN",
        "first_name": "CHRISTOPHER",
        "middle_name": "CLAYTON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-22",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Booneville, AR

Sources for this page

Verify at the official NPI Registry.