Active NPI
Dale Thomas Fallis
- General Practice Dentistry
- Little Rock, AR
National Provider Identifier
1497765903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2550
- Practice address
- 10500 W Markham St
Ste 104
Little Rock, AR 72205-2140 - Phone
- (501) 223-2773
- Fax
- (501) 223-2358
- NPI assigned
- Aug 8, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2550 | TN | Primary |
Addresses
Primary practice location
10500 W Markham St
Ste 104
Little Rock, AR 72205-2140
Mailing address
10500 W. Markham St
Ste 104
Little Rock, AR 72205
Phone (501) 223-2773
Other names 1
- Susie R Akin
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 |
|---|---|---|---|
| 2550 | TN | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497765903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10500 W. MARKHAM ST",
"address_2": "STE 104",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "72205",
"telephone_number": "501-223-2773",
"fax_number": "501-223-2358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10500 W MARKHAM ST",
"address_2": "STE 104",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722052140",
"telephone_number": "501-223-2773",
"fax_number": "501-223-2358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALLIS",
"first_name": "DALE",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TN",
"license": "2550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUSIE",
"last_name": "AKIN",
"middle_name": "R",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.