Green Dental Lab, Inc.

Primary specialty

Dental LaboratoryTaxonomy code 292200000X

License

123277-00 Issued in AR

Legal business name

GREEN DENTAL LAB, INC.

Practice address

1099 Wilburn Rd
Heber Springs, AR 72543-8905

Phone

(501) 362-3132

Fax

(501) 362-4717

NPI assigned

May 11, 2016

Last updated

May 11, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberly Thomas

Title

Lab President

Phone

(501) 362-3132

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Michael Bowman Hestir, DDS

  • Dentist
  • Heber Springs, AR
  • NPI 1083265797
  NPD (past)

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462924800000",
    "number": "1659727469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 WILBURN RD",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725438905",
            "telephone_number": "501-362-3132",
            "fax_number": "501-362-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 WILBURN RD",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725438905",
            "telephone_number": "501-362-3132",
            "fax_number": "501-362-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN DENTAL LAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-11",
        "last_updated": "2016-05-11",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "LAB PRESIDENT",
        "authorized_official_telephone_number": "501-362-3132",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": "AR",
            "license": "123277-00",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178993739",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Goodwin
• Deanna Pullig Graham, COTA/L
• John Stanley Grammer, DMD
• Joy Graves, PHARMD
• Lisa Darlene Gray
• Gail Grubbs, SPEECH THERAPIST
• Michael Joseph Hale, MSN, APRN, FNP-BC
• James Hardie, CRNA
• Harps Food Stores, Inc (Harps Pharmacy #163)
• Chelsey Harrington, COTA

• Dental Laboratory in Heber Springs, AR
• Providers in Heber Springs, AR by specialty
• Dental Laboratory in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; 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.