Individual provider Active NPI

David Mitchell Rainwater, D.D.S

  • General Practice Dentistry
  • Little Rock, AR
National Provider Identifier
1770928442
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3869 Issued in AR
Practice address
12921 Cantrell Rd Ste 301
Little Rock, AR 72223-1709
Phone
(501) 224-5511
NPI assigned
May 7, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3869 AR Primary

Addresses

Primary practice location

12921 Cantrell Rd Ste 301
Little Rock, AR 72223-1709

Mailing address

12921 Cantrell Rd Ste 301
Little Rock, AR 72223-1709
Phone (501) 224-5511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160201001328 AR Order and Referring Only - DentistPractitioner - Dentist 0840594578

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3869ARMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centre @ 10 Dental Group General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1770928442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12921 CANTRELL RD STE 301",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722231709",
            "telephone_number": "501-224-5511",
            "fax_number": "501-224-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12921 CANTRELL RD STE 301",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722231709",
            "telephone_number": "501-224-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINWATER",
        "first_name": "DAVID",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-07",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.