Individual provider Active NPI

Stephen A Rappeport, DDS

  • Periodontics
  • Fort Smith, AR
National Provider Identifier
1689626269
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2241 Issued in AR
Practice address
304 N Greenwood Ave
Fort Smith, AR 72901-3454
Phone
(479) 783-3633
Fax
(479) 783-3637
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2241 AR Primary

Addresses

Primary practice location

304 N Greenwood Ave
Fort Smith, AR 72901-3454

Mailing address

304 N Greenwood Ave
Fort Smith, AR 72901-3454
Phone (479) 783-3633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160309000989 AR Order and Referring Only - DentistPractitioner - Dentist 7416253984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2241ARMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1689626269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N GREENWOOD AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729013454",
            "telephone_number": "479-783-3633",
            "fax_number": "479-783-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N GREENWOOD AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729013454",
            "telephone_number": "479-783-3633",
            "fax_number": "479-783-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPPEPORT",
        "first_name": "STEPHEN",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AR",
            "license": "2241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.