Individual provider Active NPI

Troy Dryden John Bartels, D.D.S.,P.A.

  • General Practice Dentistry
  • Jonesboro, AR
National Provider Identifier
1619981396
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3254 Issued in AR
Practice address
811 Windover Rd Ste B
Jonesboro, AR 72401-6094
Phone
(870) 802-1500
Fax
(870) 802-1600
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3254 AR Primary

Addresses

Primary practice location

811 Windover Rd Ste B
Jonesboro, AR 72401-6094

Mailing address

811 Windover Rd Ste B
Jonesboro, AR 72401-6094
Phone (870) 802-1500

Other identifiers 2

IdentifierTypeStateIssuer
980292OtherARUNITED CONCORDIA
5U094OtherARBLUECROSS BLUESHEILD

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150623001314 AR Order and Referring Only - General PracticePractitioner - General Practice 8022207406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3254ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Troy D. Bartels DDS PA CurrentSince Nov 22, 2020 Accepting new patients

Locations

811 Windover Rd
Ste B
Jonesboro, AR 72401
Phone (870) 802-1500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619981396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 WINDOVER RD STE B",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016094",
            "telephone_number": "870-802-1500",
            "fax_number": "870-802-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 WINDOVER RD STE B",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016094",
            "telephone_number": "870-802-1500",
            "fax_number": "870-802-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTELS",
        "first_name": "TROY",
        "middle_name": "DRYDEN JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "980292",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHEILD",
            "identifier": "5U094",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.