NPIMap

Organization Active NPI

Warren Dental, PLLC

  • General Practice Dentistry
  • Clinton, AR
National Provider Identifier
1518085620
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3528 Issued in AR
Legal business name
WARREN DENTAL, PLLC
Practice address
390 Factory Rd
Suite a
Clinton, AR 72031-6742
Phone
(501) 745-4656
Fax
(501) 745-6317
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Authorized official

Name
Dr. Darryl W. Warren, D.D.S.NPI 1861412082
Title
Owner
Phone
(501) 745-4656

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 2140 AR
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 3528 AR Primary

Addresses

Primary practice location

390 Factory Rd
Suite a
Clinton, AR 72031-6742

Mailing address

390 Factory Rd
Suite a
Clinton, AR 72031-6742
Phone (501) 745-4656

Other identifiers 1

IdentifierTypeStateIssuer
187471631MedicaidAR

National Provider Directory

National Provider Directory

Locations

390 Factory Rd
Ste A
Clinton, AR 72031
Phone (501) 745-4656

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580774400000",
    "number": "1518085620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 FACTORY RD",
            "address_2": "SUITE A",
            "city": "CLINTON",
            "state": "AR",
            "postal_code": "720316742",
            "telephone_number": "501-745-4656",
            "fax_number": "501-745-6317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 FACTORY RD",
            "address_2": "SUITE A",
            "city": "CLINTON",
            "state": "AR",
            "postal_code": "720316742",
            "telephone_number": "501-745-4656",
            "fax_number": "501-745-6317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-745-4656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2140",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187471631",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.