Individual provider Active NPI

Larry E Sipes, D.D.S.

  • General Practice Dentistry
  • El Dorado, AR
National Provider Identifier
1649216656
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3301 Issued in AR
Practice address
607 N College Ave
El Dorado, AR 71730-4504
Phone
(870) 864-9788
Fax
(870) 864-9785
NPI assigned
Jun 20, 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 3301 AR Primary

Addresses

Primary practice location

607 N College Ave
El Dorado, AR 71730-4504

Mailing address

607 N College Ave
El Dorado, AR 71730-4504
Phone (870) 864-9788

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160519000199 AR Order and Referring Only - DentistPractitioner - Dentist 9830488584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Larry E Sipes DDS PA General Practice CurrentSince Feb 14, 2021 Accepting new patients

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649216656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 N COLLEGE AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304504",
            "telephone_number": "870-864-9788",
            "fax_number": "870-864-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 N COLLEGE AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304504",
            "telephone_number": "870-864-9788",
            "fax_number": "870-864-9785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIPES",
        "first_name": "LARRY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

Verify at the official NPI Registry.