Individual provider Active NPI

Trent Daiber, OD

  • Optometrist
  • Bentonville, AR
National Provider Identifier
1598438103
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2833 Issued in AR
Practice address
2300 SE J St
Bentonville, AR 72712-3776
Phone
(479) 268-3268
Fax
(479) 268-4019
NPI assigned
Jul 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2833 AR Primary

Addresses

Primary practice location

2300 SE J St
Bentonville, AR 72712-3776

Mailing address

2300 SE J St
Bentonville, AR 72712-3776
Phone (479) 268-3268

Other practice location 1

455 Slack St
Pea Ridge, AR 72751
Phone (479) 208-6175

Other practice location 2

5001 W Pauline Whitaker Pkwy Ste 125
Rogers, AR 72758-7345
Phone (479) 469-2023

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
I20211018000253 AR Practitioner - Optometry 6800294125 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bentonville Eye Care PLLCGroup PAC ID 3476899030, 7 clinicians

Practice addresses (Care Compare)

2300 SE J St
Bentonville, AR 72712-3776
Phone (479) 268-3268

455 Slack St
Pea Ridge, AR 72751-3701
Phone (479) 208-6175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2833ARMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ozark Eye, PLLC Optometrist CurrentSince May 20, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1598438103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 SE J ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123776",
            "telephone_number": "479-268-3268",
            "fax_number": "479-268-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 SE J ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123776",
            "telephone_number": "479-268-3268",
            "fax_number": "479-268-4019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Slack St",
            "address_purpose": "LOCATION",
            "city": "Pea Ridge",
            "state": "AR",
            "postal_code": "72751",
            "country_code": "US",
            "telephone_number": "479-208-6175",
            "fax_number": "479-208-6173",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5001 W Pauline Whitaker Pkwy Ste 125",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727587345",
            "country_code": "US",
            "telephone_number": "479-469-2023",
            "fax_number": "479-469-2013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAIBER",
        "first_name": "TRENT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-29",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.