Le Western Dentistry, PLLC

Key facts

NPI

1922569573

Entity type

Organization (NPI type 2)

Primary specialty

General Practice Dentistry 1223G0001X

Legal business name

LE WESTERN DENTISTRY, PLLC

Practice address

16 Church St
Charleston, AR 72933-9190

Phone

(479) 965-2291

Fax

(479) 965-2292

NPI assigned

Mar 27, 2019

Organization subpart

Yes

Parent organization (as reported)

LE WESTERN DENTISTRY, PLLC

Authorized official

Name

Cassi Lynn Work

Title

Clinic Coordinator

Phone

(479) 782-3005

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Le Western Dentistry, PLLC Point of Service · Fort Smith, AR · NPI 1154867893
  NPPES parent name

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Le Western Dentistry, PLLC Point of Service · Fort Smith, AR · NPI 1154867893
  Same enrollment O20200618001405

Corporate family (same tax ID) 1

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

• Le Western Dentistry, PLLC Point of Service · Fort Smith, AR · NPI 1154867893
  NPD tax ID

Practitioners 3

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

• Isaac Tuan Le, DDS Dentist · Fort Smith, AR · NPI 1285073635
  NPD
• Frank Griffin, DDS Dentist · Fort Smith, AR · NPI 1760166631
  NPD (past)
• Scott Harlan Taylor, D.D.S. General Practice Dentistry · Charleston, AR · NPI 1588673453
  NPD (past) GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment

Enrolled in AR

Medicare enrollment records

National Provider Directory

Tax ID family

Le Western Dentistry PLLC (2 organizations share this tax ID)

Part of

Le Western Dentistry PLLC

Locations

Specialties & licenses

Addresses

Other identifiers

Other names

• Charleston Dentistry Doing business as

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 27, 2019.

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1922569573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "CHARLESTON",
            "state": "AR",
            "postal_code": "729330308",
            "telephone_number": "479-965-2291",
            "fax_number": "479-965-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CHURCH ST",
            "city": "CHARLESTON",
            "state": "AR",
            "postal_code": "729339190",
            "telephone_number": "479-965-2291",
            "fax_number": "479-965-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LE WESTERN DENTISTRY, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LE WESTERN DENTISTRY, PLLC",
        "enumeration_date": "2019-03-27",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "WORK",
        "authorized_official_first_name": "CASSI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CLINIC COORDINATOR",
        "authorized_official_telephone_number": "479-782-3005"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1154867893",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ftsmithdentistry.com",
            "affiliation": "N",
            "endpointDescription": "secure email address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Communication",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "16 Church St",
            "city": "Charleston",
            "state": "AR",
            "country_code": "US",
            "postal_code": "729339190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Charleston Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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