West Memphis Dental Group

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

WEST MEMPHIS DENTAL GROUP

Practice address

715 Calvin Avery Dr
West Memphis, AR 72301-6501

Phone

(870) 735-3601

NPI assigned

Sep 2, 2021

Last updated

Sep 2, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brett Hildenbrand

Title

Ceo

Phone

(662) 321-5883

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630540800000",
    "number": "1780352948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416",
            "city": "SALTILLO",
            "state": "MS",
            "postal_code": "388660416",
            "telephone_number": "662-871-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 CALVIN AVERY DR",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723016501",
            "telephone_number": "870-735-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST MEMPHIS DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A",
        "authorized_official_last_name": "HILDENBRAND",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-321-5883",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wellcare Transit Inc
• Jessica Wells, WHNP-BC
• Leslie Ann Wells, MHPP
• Ronda M Welty
• Mary-Katherine Corban Werner, OT
• West Memphis Eye Center, PA (Glen Edward Bryant jr.)
• West Memphis Healthcare Center, LLC (Broadway Healthcare Center)
• West Memphis Operators LLC
• West Memphis Pet Imaging, LLC
• West Memphis School District

• Dental Clinic/Center in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Dental Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.