NPIMap

Organization Active NPI

Kendall Roberts DDS PC

  • General Practice Dentistry
  • Fort Smith, AR
National Provider Identifier
1669641098
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2787 Issued in AR
Legal business name
KENDALL ROBERTS DDS PC
Practice address
5505 Euper Lane
Fort Smith, AR 72903
Phone
(479) 478-6060
Fax
(479) 478-6986
NPI assigned
Feb 29, 2008
Organization subpart
Yes
Parent organization
KENDALL ROBERTS DDS PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Authorized official

Name
Dr. Raymond Kendall Roberts, DDS
Title
Dentist
Phone
(479) 478-6060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2787 AR Primary

Addresses

Primary practice location

5505 Euper Lane
Fort Smith, AR 72903

Mailing address

5505 Euper Lane
Fort Smith, AR 72903
Phone (479) 478-6060

Other names 1

  • New Health Dental Former legal business name

National Provider Directory

National Provider Directory
Part of
Kendall Roberts DDS PC

Locations

5505 Euper Ln
Fort Smith, AR 72903
Phone (479) 478-6060

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1669641098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 EUPER LANE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72903",
            "telephone_number": "479-478-6060",
            "fax_number": "479-478-6986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 EUPER LANE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "72903",
            "telephone_number": "479-478-6060",
            "fax_number": "479-478-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDALL ROBERTS DDS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENDALL ROBERTS DDS PC",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "KENDALL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "479-478-6060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Health Dental",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; 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.