17 Eagle Vilonia Professional LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

17 EAGLE VILONIA PROFESSIONAL LLC

Doing business as

Lane Family Dentistry

Practice address

17 Eagle Park Dr
Vilonia, AR 72173-9050

Phone

(501) 796-3903

NPI assigned

Jul 7, 2025

Last updated

Jul 7, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ashley Forsyth

Title

Payor Relations

Phone

(501) 796-3903

Specialties & licenses 1

Addresses

Other names 1

• Lane Family Dentistry Doing business as

Practitioners 1

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.

• Brian Lane

  • General Practice Dentistry
  • Vilonia, AR
  • NPI 1710072277
  NPD (past)

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

{
    "created_epoch": "1751846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1508756073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 EAGLE PARK DR",
            "city": "VILONIA",
            "state": "AR",
            "postal_code": "721739050",
            "telephone_number": "501-796-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 EAGLE PARK DR",
            "city": "VILONIA",
            "state": "AR",
            "postal_code": "721739050",
            "telephone_number": "501-796-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "17 EAGLE VILONIA PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A",
        "authorized_official_last_name": "FORSYTH",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "PAYOR RELATIONS",
        "authorized_official_telephone_number": "501-796-3903"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lane Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Alanis
• Arcare (ARcare 87)
• Morgan Elizabeth Bartley
• Lindsay Kathryn Bennett, BSW, MHPP
• Brian Michael Bowlin, M.D.

• General Practice Dentistry in Vilonia, AR
• Providers in Vilonia, 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 Jul 7, 2025; 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.