Darryl W Warren, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3528 Issued in AR

Practice address

390 Factory Rd
Suite a
Clinton, AR 72031-6742

Phone

(501) 745-4656

Fax

(501) 745-6317

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 10, 2014 through Dec 10, 2026

Medicare enrollment (NPD)

Not 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.

• Warren Dental, PLLC

  • General Practice Dentistry
  • Clinton, AR
  • NPI 1518085620
  NPD (past) Authorized official

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1861412082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 FACTORY RD",
            "address_2": "SUITE A",
            "city": "CLINTON",
            "state": "AR",
            "postal_code": "720316742",
            "telephone_number": "501-745-4656",
            "fax_number": "501-745-6317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 FACTORY RD",
            "address_2": "SUITE A",
            "city": "CLINTON",
            "state": "AR",
            "postal_code": "720316742",
            "telephone_number": "501-745-4656",
            "fax_number": "501-745-6317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "DARRYL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160018608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Henry C. Wallace, M.D.
• Wenderlain Walley, DIETARY SUPERVISOR
• Walmart Inc.
• Warren Chiropractic & Wellness Clinic, LLC
• Warren Dental, PLLC
• David Warren, D.C.
• Donald W. Warren, D.D.S.
• Kendall Washam
• Autumn Welter, RECOVERY ASSISTANT
• Kathy J West, RECOVERY ASSISTANT

• General Practice Dentistry in Clinton, AR
• Providers in Clinton, 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 Jun 16, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.