Active NPI
Greg J Simon, DDS
- General Practice Dentistry
- Conway, AR
National Provider Identifier
1841346764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3261
- Practice address
- 607 Front St
Conway, AR 72032-5419 - Phone
- (501) 327-2586
- Fax
- (501) 329-8934
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3261 | AR | Primary |
Addresses
Primary practice location
607 Front St
Conway, AR 72032-5419
Mailing address
607 Front St
Conway, AR 72032-5419
Phone (501) 327-2586
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 988211 | Other | AR | UCCI PROVIDER NUMBER |
| 5U236 | Other | AR | ARKANSAS BCBS PROVIDER # |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3261 | AR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Solutions of Central Arkansas PA | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Conway, AR
- NPI 1457405730
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841346764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 FRONT ST",
"city": "CONWAY",
"state": "AR",
"postal_code": "720325419",
"telephone_number": "501-327-2586",
"fax_number": "501-329-8934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 FRONT ST",
"city": "CONWAY",
"state": "AR",
"postal_code": "720325419",
"telephone_number": "501-327-2586",
"fax_number": "501-329-8934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "GREG",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "3261",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCCI PROVIDER NUMBER",
"identifier": "988211",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARKANSAS BCBS PROVIDER #",
"identifier": "5U236",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.