Summit Dental, Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

3917 Issued in AR

Legal business name

SUMMIT DENTAL, INC.

Practice address

12120 Col Glenn Rd
Suite 6600
Little Rock, AR 72210-2824

Phone

(501) 227-0500

Fax

(501) 227-0503

NPI assigned

Nov 5, 2013

Organization subpart

Yes

Parent organization

SUMMIT DENTAL, INC.As reported in NPPES

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

Authorized official

Name

Pam Halbrook

Title

Administrator

Phone

(501) 227-0500

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Summit Dental Inc2 organizations share this tax ID, including this one

Part of

Summit Dental Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Summit Dental, Inc

  • Dentist
  • Hot Springs, AR
  • NPI 1407172331
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Summit Dental, Inc

  • Dentist
  • Hot Springs, AR
  • NPI 1407172331
  NPPES parent name

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383609600000",
    "number": "1720417314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12120 COL GLENN RD",
            "address_2": "SUITE 6600",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722102824",
            "telephone_number": "501-227-0500",
            "fax_number": "501-227-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12120 COL GLENN RD",
            "address_2": "SUITE 6600",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722102824",
            "telephone_number": "501-227-0500",
            "fax_number": "501-227-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT DENTAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT DENTAL, INC.",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A",
        "authorized_official_last_name": "HALBROOK",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "501-227-0500"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AR",
            "license": "3917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE 3917",
            "identifier": "1780939678",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fnu Sumaiya Sharif, MD
• Tara Dyan Summerford, MS CCC SLP
• Candace Marie Summerhill, PHARMD
• Ryan Averie Summers, MS, LAT, ATC
• Alyssa Summey, D.C.
• Tiffany R Summitt, PHARMD
• Monica M Sumner, APRN, FNP-C
• Jean Sun, MD
• Jumin Sunde, M.D.
• Sarah Buckalew Sunde, DMD

• Dentist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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.