Robert Walton Bassham, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2867 Issued in AR

Practice address

669 Addison Drive
Wynne, AR 72396

Phone

(870) 238-7570

Fax

(870) 238-1208

NPI assigned

Nov 14, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Robert W Bassham DDS PA

  • General Practice Dentistry
  • Wynne, AR
  • NPI 1790394393
  NPD

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770655185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 ADDISON DRIVE",
            "address_2": "PO BOX 469",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "72396",
            "telephone_number": "870-238-7570",
            "fax_number": "870-238-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 ADDISON DRIVE",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "72396",
            "telephone_number": "870-238-7570",
            "fax_number": "870-238-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSHAM",
        "first_name": "ROBERT",
        "middle_name": "WALTON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "2867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "872310",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BC BS",
            "identifier": "58190",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy Baker
• Kayla Baker
• Mandi Machelle Ball
• Avante Banks, QBHP
• Laura Beth Bassham, M.C.D.
• Tiffany Beasley
• James Trent Beaton, M.D.
• Courtney Blake Bethell
• Guy Biggs, OTR
• Billy J. Mitchell Jr (Mitchell Eye Clinic)

• Dentist in Wynne, AR
• Providers in Wynne, AR by specialty
• Dentist in Arkansas

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.