NPIMap

Organization Active NPI

Blayne Tipton DDS PA

Doing business as Tipton Pediatric Dentistry

  • Pediatric Dentistry
  • Hot Springs, AR
National Provider Identifier
1508016163
Registry record updated Nov 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
BLAYNE TIPTON DDS PA
Doing business as
Tipton Pediatric Dentistry
Practice address
307 G Carpenter Dam Road
Hot Springs, AR 71901
Phone
(501) 520-5437
Fax
(501) 520-5433
NPI assigned
Sep 19, 2008
Last updated
Nov 22, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2017

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

Authorized official

Name
Blayne H Tipton, DDSNPI 1831301951
Title
President
Phone
(501) 520-5437

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

307 G Carpenter Dam Road
Hot Springs, AR 71901

Mailing address

307 G Carpenter Dam Road
Hot Springs, AR 71901
Phone (501) 520-5437

Other identifiers 2

IdentifierTypeStateIssuer
171064631MedicaidAR
154429608MedicaidAR

Other names 1

  • Tipton Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511308800000",
    "number": "1508016163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 G CARPENTER DAM ROAD",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "71901",
            "telephone_number": "501-520-5437",
            "fax_number": "501-520-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 G CARPENTER DAM ROAD",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "71901",
            "telephone_number": "501-520-5437",
            "fax_number": "501-520-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAYNE TIPTON DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-19",
        "last_updated": "2017-11-22",
        "status": "A",
        "authorized_official_last_name": "TIPTON",
        "authorized_official_first_name": "BLAYNE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-520-5437",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171064631",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154429608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tipton Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hot Springs, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; 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.