Individual provider Active NPI

Wendell C Thompson

  • General Practice Dentistry
  • Little Rock, AR
National Provider Identifier
1861508327
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2560 Issued in AR
Practice address
10025 W Markham St
Suite 250
Little Rock, AR 72205-1407
Phone
(501) 224-1299
Fax
(501) 224-9540
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2560 AR Primary

Addresses

Primary practice location

10025 W Markham St
Suite 250
Little Rock, AR 72205-1407

Mailing address

10025 W Markham St
Suite 250
Little Rock, AR 72205-1407
Phone (501) 224-1299

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190919000274 AR Order and Referring Only - DentistPractitioner - Dentist 2567792468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861508327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10025 W MARKHAM ST",
            "address_2": "SUITE 250",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722051407",
            "telephone_number": "501-224-1299",
            "fax_number": "501-224-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10025 W MARKHAM ST",
            "address_2": "SUITE 250",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722051407",
            "telephone_number": "501-224-1299",
            "fax_number": "501-224-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "WENDELL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.