TMJ and Facial Pain Center,LLC

Primary specialty

DentistTaxonomy code 122300000X

License

3469 Issued in AR

Legal business name

TMJ AND FACIAL PAIN CENTER,LLC

Practice address

2600 Browns Lane
Ste B
Jonesboro, AR 72404

Phone

(870) 932-7000

Fax

(870) 932-1650

NPI assigned

Sep 11, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Heather Bond Southard, DDSNPI 1376616664

Title

Owner

Phone

(870) 932-7000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heather Bond Southard, DDS

  • General Practice Dentistry
  • Jonesboro, AR
  • NPI 1376616664
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1922476571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 BROWNS LANE",
            "address_2": "STE B",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72404",
            "telephone_number": "870-932-7000",
            "fax_number": "870-932-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 BROWNS LANE",
            "address_2": "STE B",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72404",
            "telephone_number": "870-932-7000",
            "fax_number": "870-932-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TMJ AND FACIAL PAIN CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-11",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "SOUTHARD",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "BOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-932-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AR",
            "license": "3469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marty W Timmons, LPN
• Joshua M Tinsley
• Sara Frances Tinsley, MSP, CCC SLP
• Toka D Tinzie
• Jay Brent Tipton
• Kristen Renee Todanl, MHW
• Jami Annette Todd, OTR
• Kyle Toledo
• Tajuana L Toliver
• Joshua Sampson Tolleson, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.