Justin Bethel, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

3339 Issued in AR

Practice address

407 Highway 5 North
Benton, AR 72019

Phone

(501) 315-3145

Fax

(501) 794-2033

NPI assigned

Apr 2, 2008

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

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.

• Benton Family Dentistry

  • General Practice Dentistry
  • Benton, AR
  • NPI 1134646698
  NPD Authorized official
• Bethel Burris Oliver PLLC

  • General Practice Dentistry
  • Benton, AR
  • NPI 1578661914
  NPD (past)

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255564800000",
    "number": "1861665515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 HIGHWAY 5 NORTH",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "72019",
            "telephone_number": "501-315-3145",
            "fax_number": "501-794-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 HIGHWAY 5 NORTH",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "72019",
            "telephone_number": "501-315-3145",
            "fax_number": "501-794-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHEL",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-02",
        "last_updated": "2009-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Benton, RECOVERY ASSISTANT
• Jennifer Berry, RECOVERY ASSISTANT
• Kevin Berry, RECOVERY ASSISTANT
• Cecelia Bethards
• Bethel Burris Oliver PLLC
• Octavia Beverly, RECOVERY ASSISTANT
• BHC Pinnacle Pointe Hospital, Inc.
• Bailee Paige Bibb
• Kristina Bienick, RECOVERY ASSISTANT
• Mackenzie Bilodeau

• Dentist in Benton, AR
• Providers in Benton, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.