Heritage Legacy Dental Care, Inc

Primary specialty

DentistTaxonomy code 122300000X

License

3220 Issued in AR

Legal business name

HERITAGE LEGACY DENTAL CARE, INC

Practice address

7 Edenwood LN
N Little Rock, AR 72116-5105

Phone

(501) 771-4500

Fax

(901) 763-3573

NPI assigned

Feb 8, 2017

Last updated

Feb 8, 2017By 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

Dr. Wade Robertson, DDSNPI 1851468128

Title

President

Phone

(501) 771-4500

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Wade William Robertson, DDS

  • General Practice Dentistry
  • N Little Rock, AR
  • NPI 1851468128
  Authorized official Same address or phone

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486512000000",
    "number": "1659819738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 EDENWOOD LN",
            "city": "N LITTLE ROCK",
            "state": "AR",
            "postal_code": "721165105",
            "telephone_number": "501-771-4500",
            "fax_number": "901-763-3573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 EDENWOOD LN",
            "city": "N LITTLE ROCK",
            "state": "AR",
            "postal_code": "721165105",
            "telephone_number": "501-771-4500",
            "fax_number": "901-763-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE LEGACY DENTAL CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-08",
        "last_updated": "2017-02-08",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "WADE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-771-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217518608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna Kay Garrison, PHARMACY TECHNICIAN
• Glass Seating and Mobility
• Govinda Lohani MD PA
• April Hannah
• Stanley Jenkins Harris, PT, DPT
• Sean Holehouse
• Robert William Holt
• Homelink Home Health Care (Alliance Homecare Equipment)
• Horizon Orthorehab Clinic, LTD (Horizon OrthoRehab and Diagnostics)
• Hunt Physical Therapy, LLC

• Dentist in N Little Rock, AR
• Providers in N Little Rock, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; 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.