Robert Ernest Gunter, DDS
Individual provider Active NPI Dentist · Dierks, AR
NPI 1801958970 · NPPES record last updated Oct 22, 2012
Key facts
- NPI
- 1801958970
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2275 (AR)
- Practice address
- 202 East Third Street
Dierks, AR 71833-0088 - Phone
- (870) 286-2112
- Fax
- (879) 286-2113
- NPI assigned
- Dec 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150616001015 | AR | Order and Referring Only - Dentist |
4981915063 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2275 | AR | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2275 | AR | Yes |
Addresses
Primary practice location
202 East Third Street
Dierks, AR 71833-0088
Mailing address
PO Box 88
Dierks, AR 71833-0088
Phone (870) 286-2112
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102673608 | Medicaid | AR |
Other providers in Dierks, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.