Kim David Keisner, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2511 Issued in AR

Practice address

1493 Forest Hills Blvd
Ste C
Bella Vista, AR 72715-5037

Phone

(479) 855-3313

NPI assigned

Jun 15, 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

Medicare fee-for-service enrollment

Enrolled in AR

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

Practice roles

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.

• Kim D. Keisner, D.D.S., P.a.

  • Dental Clinic/Center
  • Bella Vista, AR
  • NPI 1851313746
  NPD (past) Authorized official
• Douglas a Carmical DDS PA

  • Dentist
  • Bella Vista, AR
  • NPI 1518418656
  NPD (past)

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1851396980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1493 FOREST HILLS BLVD",
            "address_2": "STE C",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727155037",
            "telephone_number": "479-855-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 FOREST HILLS BLVD",
            "address_2": "STE C",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727155037",
            "telephone_number": "479-855-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEISNER",
        "first_name": "KIM",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy M Hunter, AUD, CCC-A
• Jennifer Jo Jennings, APN
• Alisa Joy Johnson, L.M.T., PH.D.
• Scott Johnson, PTA
• Tara Joiner, LPC
• Kyle Ryan Keith
• Nicole K Keller, AU.D.
• Kelly Dundon PLLC
• Mary K Kerby, APN
• Jessica Dawn Kessler, PT

• General Practice Dentistry in Bella Vista, AR
• Providers in Bella Vista, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.