Blytheville Pediatric Dentistry, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

3647 Issued in AR

Legal business name

BLYTHEVILLE PEDIATRIC DENTISTRY, PLLC

Doing business as

Children's Dental Group

Practice address

646 E Main St Ste B
Blytheville, AR 72315-2125

Phone

(870) 824-6677

NPI assigned

Oct 23, 2013

Last updated

Oct 23, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jammie A Burrows

Title

Office Manager

Phone

(870) 739-2992

Specialties & licenses 1

Addresses

Other names 1

• Children's Dental Group Doing business as

Locations

Practitioners 1

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.

• John Michael Burrows, D.D.S.

  • Pediatric Dentistry
  • Marion, AR
  • NPI 1225211196
  NPD (past)

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382486400000",
    "number": "1891123279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 OLD HIGHWAY 64",
            "city": "CRAWFORDSVILLE",
            "state": "AR",
            "postal_code": "723272311",
            "telephone_number": "870-739-2992",
            "fax_number": "870-739-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 E MAIN ST STE B",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152125",
            "telephone_number": "870-824-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLYTHEVILLE PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-23",
        "last_updated": "2013-10-23",
        "status": "A",
        "authorized_official_last_name": "BURROWS",
        "authorized_official_first_name": "JAMMIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-739-2992",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AR",
            "license": "3647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roberta E Bevill, SBS
• Bio-Medical Applications of Arkansas, Inc. (Bma Blytheville)
• Tiara M Black
• Robert Austin Blue, PHARMD
• Blytheville Citizens Band Radio Club Inc
• Blytheville RT Associates LLC
• Board Certified Family Practice
• Deanna Renee Bogard
• Sarah Boling
• Heidi Bonifacio

• Dental Clinic/Center in Blytheville, AR
• Providers in Blytheville, AR by specialty
• Dental Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; 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.