Individual provider Active NPI

George E Arquitt III, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Springfield, MO
National Provider Identifier
1720073703
Registry record updated Mar 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
2002001969M Issued in MO
Practice address
1103 E Montclair St
Suite 100
Springfield, MO 65807-5076
Phone
(417) 887-8800
Fax
(417) 887-6265
NPI assigned
Sep 15, 2005
Last updated
Mar 31, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2002002703D MO
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2002001969M MO Primary

Addresses

Primary practice location

1103 E Montclair St
Suite 100
Springfield, MO 65807-5076

Mailing address

1103 E Montclair St
Suite 100
Springfield, MO 65807-5076
Phone (417) 887-8800

Other identifiers 6

IdentifierTypeStateIssuer
190010364OtherMORR MEDICARE
157751OtherMOBLUE CHOICE
405747700MedicaidMO
2703OtherMODELTA DENTAL
12278OtherMOBC/S DENTAL
157751OtherMOBC/S MEDICAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051129000368 MO Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 9032139605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
Vanderbilt University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gipson, Arquitt, Meyer and Shaner, DDS, PCGroup PAC ID 6103886981, 7 clinicians

Practice addresses (Care Compare)

102 Summit Dr
Branson, MO 65616-7312
Phone 41788788001254

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2002001969MMOMDOral and Maxillofacial Surgery (Dentist)
2002002703DMOMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Gipson, Arquitt, Meyer and Shaner DDS, PC Oral and Maxillofacial Surgery CurrentSince Jul 15, 2002 Accepting new patients
C. Rex Witherspoon Surgery Center Inc PastSince Sep 23, 2024 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Oral Anesthesia Group Inc Past Accepting new patients

Locations

102 SMT Dr
Branson, MO 65616

102 SMT Dr
Branson, MO 65616
Phone 41788788001254

1103 E Montclair St
Ste 100
Springfield, MO 65807
Phone (414) 887-8800

1103 E Montclair St
Ste 110
Springfield, MO 65807
Phone (417) 447-2482

Interoperability endpoints

  • Direct secure messaging: george.arquitt@cernerdirect.coxhealth.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490918400000",
    "number": "1720073703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 E MONTCLAIR ST",
            "address_2": "SUITE 100",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075076",
            "telephone_number": "417-887-8800",
            "fax_number": "417-887-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 E MONTCLAIR ST",
            "address_2": "SUITE 100",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075076",
            "telephone_number": "417-887-8800",
            "fax_number": "417-887-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARQUITT",
        "first_name": "GEORGE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2017-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "2002002703D",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "2002001969M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "190010364",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "157751",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405747700",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "2703",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/S DENTAL",
            "identifier": "12278",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/S MEDICAL",
            "identifier": "157751",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.