Andrew J Duck, DDS

Key facts

NPI

1851661003

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Dentistry 1223G0001X

License

3850 (AR)

Practice address

2111 S Old Missouri Rd
Springdale, AR 72764-8718

Phone

(479) 340-0005

NPI assigned

Jan 5, 2012

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 2, 2016.

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1851661003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 S OLD MISSOURI RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727648718",
            "telephone_number": "479-340-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 S OLD MISSOURI RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727648718",
            "telephone_number": "479-340-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCK",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-05",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

• Dr. Johnny Pearce
• Rita Marie Draggs, APRN
• Danny Elliott Drew, MD
• Mary Elizabeth Dristle, PT, DPT
• Jeanette Tho Duan, MD
• Dwight Debusk Duckworth, DDS
• Rhiannon Ducoeur, RN, APRN
• Marilyn Gay Duff, MHPP
• Ron B Dugger, PH.D.
• Timothy Dugger

All providers in Springdale, AR · General Practice Dentistry in Arkansas