Individual provider Active NPI

Alissa Totheroh Warner, DMD

  • General Practice Dentistry
  • Little Rock, AR
National Provider Identifier
1609565225
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2024017195 Issued in MO
Practice address
4301 W Markham St # 624
Little Rock, AR 72205-7199
Phone
(501) 686-8089
NPI assigned
May 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 2024017195 MO Primary

Addresses

Primary practice location

4301 W Markham St # 624
Little Rock, AR 72205-7199

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131

Other practice location 1

91 Troy Sq
Troy, MO 63379-3227
Phone (844) 853-8937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20240729003026 MO Practitioner - Dentist 6901265685 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc CurrentSince Jul 15, 2024 Accepting new patients
Compass Health, Inc CurrentSince Jul 15, 2024 Accepting new patients

Locations

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

1800 Community
#B
Clinton, MO 64735

704 E Highway 28
Owensville, MO 65066
Phone (573) 437-2959

102 Compass Point Dr
Saint Charles, MO 63301
Phone (636) 332-8318

2645 Muegge Rd
Saint Charles, MO 63303
Phone (636) 939-6868

101 Progress Pkwy
Sullivan, MO 63080
Phone (573) 468-3555

91 Troy Sq
Troy, MO 63379

1780 Old Highway 50 E
Ste 111
Union, MO 63084
Phone (636) 584-0305

19515 Brune Pkwy
Warrenton, MO 63383
Phone (636) 235-4049

1030 Wolfrum Rd
Weldon Spring, MO 63304
Phone (314) 339-7732

1032 Crosswinds Ct
Wentzville, MO 63385
Phone (636) 332-6000

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": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1609565225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 624",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057199",
            "telephone_number": "501-686-8089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91 Troy Sq",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MO",
            "postal_code": "633793227",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARNER",
        "first_name": "ALISSA",
        "middle_name": "TOTHEROH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2024017195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.