Charles Joseph Snyder, D.M.D.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DS025310L Issued in PA

Practice address

1090 Arnold Dr
Little Rock Air Force Base, AR 72099-4933

Phone

(501) 987-7304

NPI assigned

Dec 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

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

{
    "created_epoch": "1134345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1841275948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 TRADEWINDS DR",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720237057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 ARNOLD DR",
            "city": "LITTLE ROCK AIR FORCE BASE",
            "state": "AR",
            "postal_code": "720994933",
            "telephone_number": "501-987-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "CHARLES",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-12",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "PA",
            "license": "DS025310L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "DSO25310L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Anthony Olivi Jr., PA-C
• Payton Quinnell
• Anne Marie Schmidt, D.D.S.
• Lauren Nicole Smith, RN
• Myra Rutledge Smith
• Donna Jean Taylor, LCSW
• Jessika Twin Taylor, RDH
• Nathaniel Trona, MD
• Kevin Weaver Jr., M.D.
• Jessica L White

• Prosthodontics in Little Rock Air Force Base, AR
• Providers in Little Rock Air Force Base, AR by specialty
• Prosthodontics in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.