Robert Van Graybill, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

35 Issued in AR

Practice address

319 S Glenwood
Russellville, AR 72801

Phone

(479) 968-1334

Fax

(479) 968-8912

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Forrest G. Bale, DDS Oral and Maxillofacial Surgery PA

  • Dental Clinic/Center
  • Russellville, AR
  • NPI 1568715175
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659481240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 S GLENWOOD",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72801",
            "telephone_number": "479-968-1334",
            "fax_number": "479-968-8912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S GLENWOOD",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72801",
            "telephone_number": "479-968-1334",
            "fax_number": "479-968-8912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYBILL",
        "first_name": "ROBERT",
        "middle_name": "VAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AR",
            "license": "35",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AR",
            "license": "2207",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanner S Goulet, PTA
• Grace Counseling and Consulting
• Grace Counseling, Inc.
• Maureen Grace
• Darrell S Gray Jr., DPT
• Shawna Dee Grayham, STATE LICENSE
• Nicole Greathouse
• Brianna Green, LAC
• Kari Green, MHPP
• Lauren Green

• Oral and Maxillofacial Surgery (Dentist) in Russellville, AR
• Providers in Russellville, AR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.