NPIMap

Organization Active NPI

Dental Health Associates of Arkansas, P.a.

Doing business as MyDentist-Forth Smith

  • General Practice Dentistry
  • Fort Smith, AR
National Provider Identifier
1760802763
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL HEALTH ASSOCIATES OF ARKANSAS, P.A.
Doing business as
MyDentist-Forth Smith
Practice address
6323 Rogers Ave
Fort Smith, AR 72903-3945
Phone
(479) 434-5888
NPI assigned
Apr 17, 2014
Last updated
Nov 5, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL HEALTH ASSOCIATES OF ARKANSAS, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Authorized official

Name
Kendra Walker
Title
Credentialing Coordinator
Phone
(217) 540-8312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

6323 Rogers Ave
Fort Smith, AR 72903-3945

Mailing address

6323 Rogers Ave
Fort Smith, AR 72903-3945

Other names 1

  • MyDentist-Forth Smith Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dr Johnny Pearce7 organizations share this tax ID, including this one
Part of
Dr Johnny Pearce

Other organizations with this tax ID 6

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

Locations

6323 Rogers Ave
Fort Smith, AR 72903
Phone (479) 434-5888

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446681600000",
    "number": "1760802763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6323 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729033945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6323 ROGERS AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729033945",
            "telephone_number": "479-434-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEALTH ASSOCIATES OF ARKANSAS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL HEALTH ASSOCIATES OF ARKANSAS, P.A.",
        "enumeration_date": "2014-04-17",
        "last_updated": "2015-11-05",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8312"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyDentist-Forth Smith",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.