NPIMap

Organization Active NPI

Premier Dental,PLLC

  • Dentist
  • Fayetteville, AR
National Provider Identifier
1801210844
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3473 Issued in AR
Legal business name
PREMIER DENTAL,PLLC
Practice address
1438 E. Augustine Lane
Suite 1
Fayetteville, AR 72703-4943
Phone
(479) 251-9000
Fax
(479) 251-9002
NPI assigned
Feb 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Authorized official

Name
Leann Sargent
Title
Office Manager
Phone
(479) 251-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 3473 AR Primary

Addresses

Primary practice location

1438 E. Augustine Lane
Suite 1
Fayetteville, AR 72703-4943

Mailing address

1438 E. Augustine Lane
Suite 1
Fayetteville, AR 72703-4943
Phone (479) 251-9000

National Provider Directory

National Provider Directory

Locations

1438 E Augustine Ln
Ste 1
Fayetteville, AR 72703
Phone (479) 251-9000

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1801210844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 E. AUGUSTINE LANE",
            "address_2": "SUITE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034943",
            "telephone_number": "479-251-9000",
            "fax_number": "479-251-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 E. AUGUSTINE LANE",
            "address_2": "SUITE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034943",
            "telephone_number": "479-251-9000",
            "fax_number": "479-251-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DENTAL,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-11",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "SARGENT",
        "authorized_official_first_name": "LEANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "479-251-9000"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AR",
            "license": "3473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.