NPIMap

Organization Active NPI

Bethel Burris Oliver, PLLC

Doing business as Arkansas Dentistry and Braces

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Clarksville, AR
National Provider Identifier
1922437748
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
3465 Issued in AR
Legal business name
BETHEL BURRIS OLIVER, PLLC
Doing business as
Arkansas Dentistry and Braces
Practice address
1126 S Rogers St
Clarksville, AR 72830-9157
Phone
(479) 754-6084
Fax
(479) 754-7646
NPI assigned
Nov 2, 2013
Last updated
Mar 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Authorized official

Name
Dr. Benjamin Burris, DDS, MDS, PA
Title
Owner
Phone
(479) 443-1705

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 3339 AR
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 3460 AR
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 4013 AR
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 3465 AR Primary

Addresses

Primary practice location

1126 S Rogers St
Clarksville, AR 72830-9157

Mailing address

3782 N Front St Ste 1
Fayetteville, AR 72703-5906
Phone (479) 443-1705

Other names 1

  • Arkansas Dentistry and Braces Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Arkansas Dentistry and Braces22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

1126 S Rogers St
Clarksville, AR 72830
Phone (479) 754-6084

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1922437748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3782 N FRONT ST STE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035906",
            "telephone_number": "479-443-1705",
            "fax_number": "479-443-1586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 S ROGERS ST",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728309157",
            "telephone_number": "479-754-6084",
            "fax_number": "479-754-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL BURRIS OLIVER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "BURRIS",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-443-1705",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MDS, PA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3339",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AR",
            "license": "3460",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AR",
            "license": "4013",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AR",
            "license": "3465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arkansas Dentistry and Braces",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.