Jeff a. Powell, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3268 Issued in AR

Legal business name

JEFF A. POWELL, D.D.S.

Practice address

7522 Highway 107
Sherwood, AR 72120-4645

Phone

(501) 834-4800

Fax

(501) 833-1414

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jeff A Powell, D.D.S.

Title

President

Phone

(501) 834-4800

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341273600000",
    "number": "1679669535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7522 HIGHWAY 107",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721204645",
            "telephone_number": "501-834-4800",
            "fax_number": "501-833-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7522 HIGHWAY 107",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721204645",
            "telephone_number": "501-834-4800",
            "fax_number": "501-833-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF A. POWELL, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2012-07-03",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-834-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134195608",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "5T971",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "975116",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; 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.