Active NPI
Tanner Alin Matone, DDS
- General Practice Dentistry
- Benton, AR
National Provider Identifier
1962074294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4541
- Practice address
- 407 Ar-5
Benton, AR 72019 - Phone
- (507) 315-1512
- NPI assigned
- Jul 15, 2021
- Last updated
- Nov 2, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4541 | AR | Primary |
Addresses
Primary practice location
407 Ar-5
Benton, AR 72019
Mailing address
14107 Ridgewood Dr
Little Rock, AR 72211-4525
Phone (901) 828-2150
Other practice location 1
307 Carpenter Dam Rd Ste M
Hot Springs, AR 71901-8282
Phone (501) 324-3323
Other practice location 2
1600 E Oak St Ste B
Conway, AR 72032-4740
Phone (501) 358-4101
Other practice location 3
123 N Center St
Lonoke, AR 72086-2805
Phone (507) 676-6770
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4541 | AR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Oak Dental PA | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667347200000",
"number": "1962074294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14107 RIDGEWOOD DR",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722114525",
"telephone_number": "901-828-2150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 AR-5",
"city": "BENTON",
"state": "AR",
"postal_code": "72019",
"telephone_number": "507-315-1512"
}
],
"practiceLocations": [
{
"address_1": "307 Carpenter Dam Rd Ste M",
"address_purpose": "LOCATION",
"city": "Hot Springs",
"state": "AR",
"postal_code": "719018282",
"country_code": "US",
"telephone_number": "501-324-3323",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1600 E Oak St Ste B",
"address_purpose": "LOCATION",
"city": "Conway",
"state": "AR",
"postal_code": "720324740",
"country_code": "US",
"telephone_number": "501-358-4101",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "123 N Center St",
"address_purpose": "LOCATION",
"city": "Lonoke",
"state": "AR",
"postal_code": "720862805",
"country_code": "US",
"telephone_number": "507-676-6770",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATONE",
"first_name": "TANNER",
"middle_name": "ALIN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-15",
"last_updated": "2022-11-02",
"certification_date": "2022-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "4541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.