Russellville Family Dentistry PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3895 Issued in AR

Legal business name

RUSSELLVILLE FAMILY DENTISTRY PA

Practice address

104 N Utah Ave
Russellville, AR 72801-2740

Phone

(479) 968-1706

NPI assigned

Dec 25, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Michael Gregory Kitchens, D.D.S.NPI 1447515770

Title

President

Phone

(479) 968-1706

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Gregory Kitchens, D.D.S.

  • Dentist
  • Russellville, AR
  • NPI 1447515770
  NPD (past) Authorized official
• Robert A Young Jr., DDS

  • Dentist
  • Russellville, AR
  • NPI 1518077601
  NPD (past)

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

{
    "created_epoch": "1387929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387929600000",
    "number": "1508287251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N UTAH AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012740",
            "telephone_number": "479-968-1706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N UTAH AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012740",
            "telephone_number": "479-968-1706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELLVILLE FAMILY DENTISTRY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-25",
        "last_updated": "2013-12-25",
        "status": "A",
        "authorized_official_last_name": "KITCHENS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-968-1706",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russellville Care Center Inc
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• Russellville Ear Nose and Throat Surgery Clinic, P.a.
• Russellville Eye Clinic, P.a.
• Russellville Family Clinic PA
• Russellville Gastroenterology Clinic PA
• Russellville Gynecology Clinic
• Russellville Holdings LLC
• Russellville Holdings LLC
• Russellville Holdings LLC

• General Practice Dentistry in Russellville, AR
• Providers in Russellville, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 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.