Active NPI
Samuel James Hutton, DDS
- Dentist
- Jonesboro, AR
National Provider Identifier
1588015069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4119
- Practice address
- 2500 Browns LN Ste B
Jonesboro, AR 72401-6107 - Phone
- (870) 972-1200
- NPI assigned
- Jun 27, 2016
- Last updated
- Jun 27, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4119 | AR | Primary |
Addresses
Primary practice location
2500 Browns LN Ste B
Jonesboro, AR 72401-6107
Mailing address
1169 Union Ave Apt 453
Memphis, TN 38104-6679
Phone (931) 797-5748
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4119 | AR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ronald S Burnett DDS PA | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Jonesboro, AR
- NPI 1417213034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466985600000",
"number": "1588015069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1169 UNION AVE APT 453",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381046679",
"telephone_number": "931-797-5748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 BROWNS LN STE B",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724016107",
"telephone_number": "870-972-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUTTON",
"first_name": "SAMUEL",
"middle_name": "JAMES",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-27",
"last_updated": "2016-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "4119",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.