NPIMap

Organization Active NPI

Carroll Family Dentistry PLLC

  • Dental Clinic/Center
  • Benton, AR
National Provider Identifier
1598508178
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
CARROLL FAMILY DENTISTRY PLLC
Practice address
1202 Hwy 35 N
Benton, AR 72019-2328
Phone
(501) 776-0620
NPI assigned
Jun 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Authorized official

Name
Ann Pevahouse, DDSNPI 1144088246
Title
General Denist
Phone
(501) 776-0620

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1202 Hwy 35 N
Benton, AR 72019-2328

Mailing address

1202 Hwy 35 N
Benton, AR 72019-2328
Phone (501) 776-0620

National Provider Directory

National Provider Directory

Locations

1202 Highway 35 N
Benton, AR 72019
Phone (501) 776-0620

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": "1718236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1598508178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 HWY 35 N",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720192328",
            "telephone_number": "501-776-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 HWY 35 N",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720192328",
            "telephone_number": "501-776-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLL FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "PEVAHOUSE",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "GENERAL DENIST",
        "authorized_official_telephone_number": "501-776-0620",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.