Kristi Tennille Gorman, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3722 Issued in AR

Practice address

805 N 20TH PL
Rogers, AR 72756-3571

Phone

(479) 234-2089

NPI assigned

Oct 14, 2009

Last updated

Sep 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1700111440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 SE FULLERTON ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124276",
            "telephone_number": "479-234-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N 20TH PL",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727563571",
            "telephone_number": "479-234-2089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5518 W Walsh Ln",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727588947",
            "country_code": "US",
            "telephone_number": "479-348-2348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "KRISTI",
        "middle_name": "TENNILLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-14",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Lee Goodman, CCC-SLP
• Jenna Goodwin, LCSW
• Jill Marie Goodwin, M.S., CCC-SLP
• Taylor Lane Gookin, OTR
• Courtney Jean Gorden, MS, RD
• Lauren Elizabeth Gorton, MD
• Emily Elaine Goucher, APRN, WHNP-BC
• Lindsey Ann Goucher, APRN
• GPB Enterprises LLC
• Alyssa Eden Graff, PA

• General Practice Dentistry in Rogers, AR
• Providers in Rogers, 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 13, 2023; 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.