NPIMap

Organization Active NPI

P & D Enterprises of Jonesboro PLLC

  • General Practice Dentistry
  • Trumann, AR
National Provider Identifier
1821302233
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2621 Issued in AR
Legal business name
P & D ENTERPRISES OF JONESBORO PLLC
Doing business as
Northeast Arkansas Dental Clinic
Practice address
405 Highway 463 N
Trumann, AR 72472-3702
Phone
(870) 483-0543
Fax
(870) 483-0544
NPI assigned
Jul 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Authorized official

Name
Diane Secrease
Title
Ofc Manager
Phone
(870) 483-0543

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2621 AR Primary

Addresses

Primary practice location

405 Highway 463 N
Trumann, AR 72472-3702

Mailing address

405 Highway 463 N
Trumann, AR 72472-3702
Phone (870) 483-0543

Other names 1

  • Northeast Arkansas Dental Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

405 Highway 463 N
Trumann, AR 72472
Phone (870) 483-0543

NPI Registry JSON

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280275200000",
    "number": "1821302233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 HIGHWAY 463 N",
            "city": "TRUMANN",
            "state": "AR",
            "postal_code": "724723702",
            "telephone_number": "870-483-0543",
            "fax_number": "870-483-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 HIGHWAY 463 N",
            "city": "TRUMANN",
            "state": "AR",
            "postal_code": "724723702",
            "telephone_number": "870-483-0543",
            "fax_number": "870-483-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P & D ENTERPRISES OF JONESBORO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-28",
        "last_updated": "2010-07-28",
        "status": "A",
        "authorized_official_last_name": "SECREASE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OFC MANAGER",
        "authorized_official_telephone_number": "870-483-0543"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Arkansas Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trumann, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; 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.