Charles E. Kauffman Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2368 Issued in AR

Practice address

305 Graham St
Fordyce, AR 71742-3230

Phone

(870) 352-2880

NPI assigned

Jul 13, 2006

Last updated

Jul 30, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Charles E Kauffman Jr DDS

  • Clinic/Center
  • Fordyce, AR
  • NPI 1871175109
  NPD Authorized official
• Kauffman Dental Clinic, PLLC

  • Dental Clinic/Center
  • Fordyce, AR
  • NPI 1982289286
  NPD Authorized official

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1770508491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 GRAHAM ST",
            "city": "FORDYCE",
            "state": "AR",
            "postal_code": "717423230",
            "telephone_number": "870-352-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 GRAHAM ST",
            "city": "FORDYCE",
            "state": "AR",
            "postal_code": "717423230",
            "telephone_number": "870-352-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFFMAN",
        "first_name": "CHARLES",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102071608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Obbie James, MHPP
• Eric Johnson, M.S., L.M.F.T.
• Rebekah Johnson, MHPP
• Susan Kay Johnson, RN
• Kauffman Dental Clinic, PLLC
• Melanie Renee Kauffman, CCC-SLP
• Deirdra Sandoral Kervin, MHPP
• Shanna Lamb
• Lekita Lee, M.S., L.M.S.W.
• Lindsey Walley MD PLLC PA (Nutt-Walley Clinic)

• General Practice Dentistry in Fordyce, AR
• Providers in Fordyce, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.