Michael Bourns, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2247 Issued in AR

Practice address

1202 Highway 35 N
Benton, AR 72015-2328

Phone

(501) 776-0620

Fax

(501) 776-0844

NPI assigned

Jul 28, 2006

Last updated

Jul 8, 2007By 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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Carroll Family Dentistry PLLC

  • Dental Clinic/Center
  • Benton, AR
  • NPI 1598508178
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801800578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 HIGHWAY 35 N",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152328",
            "telephone_number": "501-776-0620",
            "fax_number": "501-776-0844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 HIGHWAY 35 N",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152328",
            "telephone_number": "501-776-0620",
            "fax_number": "501-776-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNS",
        "first_name": "MICHAEL",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Borneman, RECOVERY ASSISTANT
• Elizabeth K. Boschetti, MA,CFY-SLP
• Nicholas Bostad, RECOVERY ASSISTANT
• Stephanie A Bostad, RECOVERY ADVOCATE
• Andrea Renee Boston, PLMSW
• Molly Bowers, MD
• Lisa M Bowman, MS, RD, LD
• Timothy Bowser, RECOVERY ASSISTANT
• Callie Boyce
• Corey Boyd, RECOVERY ASSISTANT

• General Practice Dentistry in Benton, AR
• Providers in Benton, 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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.