At Ease Dental, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

4275 Issued in AR

Legal business name

AT EASE DENTAL, LLC

Practice address

701 NW McNelly Rd Ste 13
Bentonville, AR 72712-9160

Phone

(479) 553-9225

NPI assigned

Jun 21, 2018

Organization subpart

No

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

Authorized official

Name

Dr. James Tristan Ray Hudson, DDSNPI 1699266338

Title

Owner

Phone

(479) 871-4313

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Tristan Ray Hudson, DDS

  • General Practice Dentistry
  • Rogers, AR
  • NPI 1699266338
  NPD Authorized official

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1629562616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 S DODSON RD APT Q4",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727587318",
            "telephone_number": "479-871-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 NW MCNELLY RD STE 13",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727129160",
            "telephone_number": "479-553-9225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT EASE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "TRISTAN RAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-871-4313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AR",
            "license": "4275",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "7052",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "2018018775",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.