Clarence W. Dill III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2075 Issued in AR

Practice address

2646 E Joyce Boulevard Suite #1
Fayetteville, AR 72703

Phone

(479) 443-4440

Fax

(479) 443-4450

NPI assigned

Aug 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bill C.W. Dill III Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: clarance.dill@bmrhc.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bill C.W. Dill III DDS

  • Dental Clinic/Center
  • Fayetteville, AR
  • NPI 1710117734
  NPD (past)
• Kellie E Barnes DDS PLLC

  • Dental Clinic/Center
  • Fayetteville, AR
  • NPI 1558695601
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1689687014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2646 E JOYCE BOULEVARD SUITE #1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-443-4440",
            "fax_number": "479-443-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2646 E JOYCE BOULEVARD SUITE #1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-443-4440",
            "fax_number": "479-443-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILL",
        "first_name": "CLARENCE",
        "middle_name": "W.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160839608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BILL",
            "last_name": "DILL",
            "middle_name": "C.W.",
            "suffix": "III",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ernestine Dickson, MSW, LCSW
• Jonathan David Dickson, PA-C
• Dawn Allyson Didier, ATC, LAT
• Shawna Kay Digby, RN, MNSC
• Bradley Dilday, M.D.
• Nicole Dill, LPC
• Barbara Dillon, LPC
• Peyten Dillon, DC
• Brenda O. Dimauro, C.P.N.P.
• Alyssa Rachel Dimitrov, DPT

• General Practice Dentistry in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.