Organization Active NPI

Bill C.W. Dill III DDS

  • Dental Clinic/Center
  • Fayetteville, AR
National Provider Identifier
1710117734
Registry record updated Jul 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BILL C.W. DILL III DDS
Practice address
2646 E Joyce Blvd Ste 1
Fayetteville, AR 72703-4435
Phone
(479) 443-4440
Fax
(479) 443-4450
NPI assigned
Jul 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2009

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

Authorized official

Name
Bill CW Dill III, DDS
Title
Owner/Dentist
Phone
(479) 443-4440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2646 E Joyce Blvd Ste 1
Fayetteville, AR 72703-4435

Mailing address

2646 E Joyce Blvd Ste 1
Fayetteville, AR 72703-4435
Phone (479) 443-4440

Other identifiers 2

IdentifierTypeStateIssuer
58122OtherARBLUE CROSS BLUE SHIELD
160839608MedicaidAR

National Provider Directory

National Provider Directory

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": "1248393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248393600000",
    "number": "1710117734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2646 E JOYCE BLVD STE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034435",
            "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 BLVD STE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034435",
            "telephone_number": "479-443-4440",
            "fax_number": "479-443-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BILL C.W. DILL III DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-24",
        "last_updated": "2009-07-24",
        "status": "A",
        "authorized_official_last_name": "DILL",
        "authorized_official_first_name": "BILL",
        "authorized_official_middle_name": "CW",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "479-443-4440",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "58122",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160839608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.