Individual provider Active NPI

Douglas A Carmical, D.D.S.

  • Dentist
  • Bella Vista, AR
National Provider Identifier
1952508327
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2951 Issued in AR
Practice address
1198 Forest Hills Blvd Ste 107
Bella Vista, AR 72715-2391
Phone
(479) 855-3313
Fax
(479) 855-4314
NPI assigned
Jun 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2951 AR Primary

Addresses

Primary practice location

1198 Forest Hills Blvd Ste 107
Bella Vista, AR 72715-2391

Mailing address

1198 Forest Hills Blvd Ste 107
Bella Vista, AR 72715-2391
Phone (479) 855-3313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2951ARMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas a Carmical DDS PA Dentist CurrentSince Aug 18, 2024 Accepting new patients
M. Trent Gubler, DDS, PC Past Accepting new patients

Locations

1198 Forest Hills Blvd
Ste 107
Bella Vista, AR 72715
Phone (479) 855-3313

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1952508327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1198 FOREST HILLS BLVD STE 107",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727152391",
            "telephone_number": "479-855-3313",
            "fax_number": "479-855-4314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1198 FOREST HILLS BLVD STE 107",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727152391",
            "telephone_number": "479-855-3313",
            "fax_number": "479-855-4314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMICAL",
        "first_name": "DOUGLAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "2951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bella Vista, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.