NPIMap

Organization Active NPI

Dardanelle Family Dentistry

  • Dentist
  • Dardanelle, AR
National Provider Identifier
1508246489
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DARDANELLE FAMILY DENTISTRY
Doing business as
Dardanelle Family Dentistry
Practice address
2533 State Highway 22 W
Dardanelle, AR 72834-8831
Phone
(479) 229-3891
NPI assigned
Jun 4, 2015
Last updated
Aug 31, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Authorized official

Name
Katie Elizabeth Crow-Goates, DDS, PLLCNPI 1902286453
Title
Owner
Phone
(479) 229-3891

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
Dentist 122300000X NU Primary

Addresses

Primary practice location

2533 State Highway 22 W
Dardanelle, AR 72834-8831

Mailing address

PO Box 447
Dardanelle, AR 72834-0447
Phone (479) 229-3891

Other identifiers 1

IdentifierTypeStateIssuer
4037OtherARASBDE LICENSE

Other names 1

  • Dardanelle Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

2533 State Highway 22 W
Dardanelle, AR 72834
Phone (479) 229-3891

Practitioners & affiliated clinicians

Practitioners 3

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": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1508246489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 447",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728340447",
            "telephone_number": "479-229-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2533 STATE HIGHWAY 22 W",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728348831",
            "telephone_number": "479-229-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DARDANELLE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A",
        "authorized_official_last_name": "CROW-GOATES",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-229-3891",
        "authorized_official_credential": "DDS, PLLC"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASBDE LICENSE",
            "identifier": "4037",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dardanelle Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dardanelle, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.