NPIMap

Organization Active NPI

Arkansas Family Dental, PA

  • General Practice Dentistry
  • Little Rock, AR
National Provider Identifier
1952431868
Registry record updated Apr 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3311 Issued in AR
Legal business name
ARKANSAS FAMILY DENTAL, PA
Practice address
13600 David O. Dodd
Little Rock, AR 72210
Phone
(501) 312-7576
Fax
(501) 687-0669
NPI assigned
Mar 7, 2007
Last updated
Apr 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2013

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

Authorized official

Name
Tina Nichols, DDSNPI 1457377012
Title
Owner/Dentist
Phone
(501) 312-7576

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3435 AR
General Practice Dentistry 1223G0001X 3311 AR Primary

Addresses

Primary practice location

13600 David O. Dodd
Little Rock, AR 72210

Mailing address

13600 David O. Dodd
Little Rock, AR 72210
Phone (501) 312-7576

Other identifiers 1

IdentifierTypeStateIssuer
181913631MedicaidAR

Other names 1

  • Tina H. Nichols, DDS, PA Former legal business name

National Provider Directory

National Provider Directory

Locations

13600 David O Dodd Rd
Little Rock, AR 72210
Phone (501) 312-7576

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366848000000",
    "number": "1952431868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13600 DAVID O. DODD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72210",
            "telephone_number": "501-312-7576",
            "fax_number": "501-687-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13600 DAVID O. DODD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72210",
            "telephone_number": "501-312-7576",
            "fax_number": "501-687-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS FAMILY DENTAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2013-04-25",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "501-312-7576",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3435",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181913631",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tina H. Nichols, DDS, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; 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.