NPIMap

Organization Active NPI

Higginbotham Dental Group, PLLC

Doing business as Higginbotham Family dental

  • General Practice Dentistry
  • Paragould, AR
National Provider Identifier
1912274630
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3393 Issued in AR
Legal business name
HIGGINBOTHAM DENTAL GROUP, PLLC
Doing business as
Higginbotham Family dental
Practice address
2200 W Kingshighway
Paragould, AR 72450-3917
Phone
(870) 215-0058
Fax
(870) 565-1029
NPI assigned
Nov 23, 2011
Last updated
Oct 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Authorized official

Name
Misti Ross
Title
Ins Director
Phone
(870) 336-3732

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3393 AR Primary

Addresses

Primary practice location

2200 W Kingshighway
Paragould, AR 72450-3917

Mailing address

1804 Old Greensboro Rd BLDG B
Jonesboro, AR 72405-0003
Phone (870) 336-3732

Other names 1

  • Higginbotham Family dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Higginbotham Dental Group PLLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

2200 W Kingshighway
Paragould, AR 72450
Phone (870) 215-0058

NPI Registry JSON

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602633600000",
    "number": "1912274630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 OLD GREENSBORO RD BLDG B",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724050003",
            "telephone_number": "870-336-3732",
            "fax_number": "870-565-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W KINGSHIGHWAY",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724503917",
            "telephone_number": "870-215-0058",
            "fax_number": "870-565-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGGINBOTHAM DENTAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-23",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "MISTI",
        "authorized_official_title_or_position": "INS DIRECTOR",
        "authorized_official_telephone_number": "870-336-3732"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Higginbotham Family dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paragould, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.