Billy J Graham

Primary specialty

DentistTaxonomy code 122300000X

License

152 Issued in AR

Legal business name

BILLY J GRAHAM

Practice address

611 Jefferson St
Van Buren, AR 72956

Phone

(479) 474-2701

Fax

(479) 474-3977

NPI assigned

Aug 22, 2006

Last updated

Aug 22, 2020By 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

Billy Joe Graham, DDS

Title

Owner/Dentist

Phone

(479) 474-2701

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952417040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 475",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729570475",
            "telephone_number": "479-474-2701",
            "fax_number": "479-474-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 JEFFERSON ST",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "72956",
            "telephone_number": "479-474-2701",
            "fax_number": "479-474-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BILLY J GRAHAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "BILLY",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "479-474-2701",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "152",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "1930",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "58238",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "843764",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beverly Enterprises - Arkansas, Inc. (Golden LivingCenter - Van Buren)
• Ashley Beyerle
• Bill Pickard, DDS, Ms, PA (Arkansas Orthodontics)
• Billy C Criswell Inc
• Billy C Criswell Inc (Criswell Dental Clinic)
• Hillary Joyce Black
• Gracie Renee Blake
• Harley Rose Blevins
• Natalie Boggs
• Bonnie Kathleen LCSW PLLC

• Dentist in Van Buren, AR
• Providers in Van Buren, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.