Individual provider Active NPI

Douglas J Gammenthaler, DDS

  • Dentist
  • Rogers, AR
National Provider Identifier
1821582842
Registry record updated Jun 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4289 Issued in AR
Practice address
2886 W Walnut St
Rogers, AR 72756-0335
Phone
(479) 899-6444
Fax
(479) 899-6605
NPI assigned
Jun 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4289 AR Primary

Addresses

Primary practice location

2886 W Walnut St
Rogers, AR 72756-0335

Mailing address

2886 W Walnut St
Rogers, AR 72756-0335
Phone (479) 899-6444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4289ARMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1821582842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2886 W WALNUT ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727560335",
            "telephone_number": "479-899-6444",
            "fax_number": "479-899-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2886 W WALNUT ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727560335",
            "telephone_number": "479-899-6444",
            "fax_number": "479-899-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMMENTHALER",
        "first_name": "DOUGLAS",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "4289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; 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.