Individual provider Active NPI

Paul L Winborn II, DDS

  • General Practice Dentistry
  • Fort Smith, AR
National Provider Identifier
1508824590
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3295 Issued in AR
Practice address
1501 S Waldron Rd
St. 208
Fort Smith, AR 72903-2574
Phone
(479) 478-9955
Fax
(479) 478-6632
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3295 AR Primary

Addresses

Primary practice location

1501 S Waldron Rd
St. 208
Fort Smith, AR 72903-2574

Mailing address

1501 S Waldron Rd
St. 208
Fort Smith, AR 72903-2574
Phone (479) 478-9955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160721001053 AR Order and Referring Only - DentistPractitioner - Dentist 6103119631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1508824590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S WALDRON RD",
            "address_2": "ST. 208",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032574",
            "telephone_number": "479-478-9955",
            "fax_number": "479-478-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S WALDRON RD",
            "address_2": "ST. 208",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032574",
            "telephone_number": "479-478-9955",
            "fax_number": "479-478-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINBORN",
        "first_name": "PAUL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.