NPIMap

Organization Active NPI

Bethel Burris Oliver

Doing business as Arkansas Dentistry and Braces

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Paragould, AR
National Provider Identifier
1609234269
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
BETHEL BURRIS OLIVER
Doing business as
Arkansas Dentistry and Braces
Practice address
2713 W Kings Highway
Paragould, AR 72450
Phone
(479) 445-6335
Fax
(479) 301-2878
NPI assigned
Feb 10, 2016
Last updated
Feb 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Authorized official

Name
Benjamin Burris, DDS, MDS
Title
Owner
Phone
(479) 445-6335

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU
Pediatric Dentistry 1223P0221X NU
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU Primary

Addresses

Primary practice location

2713 W Kings Highway
Paragould, AR 72450

Mailing address

4375 N Vantage Dr
Suite 202
Fayetteville, AR 72703-4982
Phone (479) 445-6335

Other names 1

  • Arkansas Dentistry and Braces Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Arkansas Dentistry and Braces22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Locations

2713 W Kingshighway
Paragould, AR 72450
Phone (870) 627-3302

NPI Registry JSON

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455062400000",
    "number": "1609234269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 N VANTAGE DR",
            "address_2": "SUITE 202",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034982",
            "telephone_number": "479-445-6335",
            "fax_number": "479-301-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2713 W KINGS HIGHWAY",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "72450",
            "telephone_number": "479-445-6335",
            "fax_number": "479-301-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL BURRIS OLIVER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-10",
        "last_updated": "2016-02-10",
        "status": "A",
        "authorized_official_last_name": "BURRIS",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-445-6335",
        "authorized_official_credential": "DDS, MDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arkansas Dentistry and Braces",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paragould, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.

Verify at the official NPI Registry.