Active NPI
John Steven Durmon, D.D.S.
- General Practice Dentistry
- Warren, AR
National Provider Identifier
1730250036
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Feb 20, 2020.
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- ARK 2697
- Practice address
- 103 W Church St
Warren, AR 71671-2809 - Phone
- (870) 226-5165
- NPI assigned
- Nov 10, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | ARK 2697 | AR | Primary |
Addresses
Primary practice location
103 W Church St
Warren, AR 71671-2809
Mailing address
103 W Church St
Warren, AR 71671-2809
Phone (870) 226-5165
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 56551 | Other | AR | BLUE CROSS BLUE SHIELDS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARK 2697 | AR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730250036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 W CHURCH ST",
"city": "WARREN",
"state": "AR",
"postal_code": "716712809",
"telephone_number": "870-226-5165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 W CHURCH ST",
"city": "WARREN",
"state": "AR",
"postal_code": "716712809",
"telephone_number": "870-226-5165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURMON",
"first_name": "JOHN",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "ARK 2697",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELDS",
"identifier": "56551",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warren, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.