NPIMap

Organization Active NPI

Montgomery Heathman DDS, PA

  • Dentist
  • Little Rock, AR
National Provider Identifier
1851750897
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3333 Issued in AR
Legal business name
MONTGOMERY HEATHMAN DDS, PA
Practice address
12501 Cantrell Rd
Little Rock, AR 72223-1639
Phone
(501) 223-3838
Fax
(501) 223-2554
NPI assigned
Feb 18, 2016
Last updated
Feb 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Authorized official

Name
Dr. Montgomery D Heathman, DDSNPI 1821182577
Title
Dentist
Phone
(479) 856-5588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3333 AR Primary

Addresses

Primary practice location

12501 Cantrell Rd
Little Rock, AR 72223-1639

Mailing address

12501 Cantrell Rd
Little Rock, AR 72223-1639
Phone (501) 223-3838

Other identifiers 1

IdentifierTypeStateIssuer
161458608MedicaidAR

National Provider Directory

National Provider Directory
Tax ID family
Montgomery D Heathman DDS PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12501 Cantrell Rd
Little Rock, AR 72223
Phone (501) 223-3838

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1851750897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 CANTRELL RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722231639",
            "telephone_number": "501-223-3838",
            "fax_number": "501-223-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 CANTRELL RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722231639",
            "telephone_number": "501-223-3838",
            "fax_number": "501-223-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY HEATHMAN DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-18",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "HEATHMAN",
        "authorized_official_first_name": "MONTGOMERY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "479-856-5588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161458608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; 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.