NPIMap

Organization Active NPI

M. Trent Gubler, DDS, PC

Doing business as Lifetime Dental

  • General Practice Dentistry
  • Rogers, AR
National Provider Identifier
1962827857
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3920 Issued in AR
Legal business name
M. TRENT GUBLER, DDS, PC
Doing business as
Lifetime Dental
Practice address
805 N 20TH PL Ste 2
Rogers, AR 72756-3571
Phone
(479) 631-9393
Fax
(479) 986-0905
NPI assigned
Feb 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Authorized official

Name
Michael Trent Gubler, DDSNPI 1326062357
Title
Owner
Phone
(479) 631-9393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3920 AR Primary

Addresses

Primary practice location

805 N 20TH PL Ste 2
Rogers, AR 72756-3571

Mailing address

805 N 20TH PL Ste 2
Rogers, AR 72756-3571
Phone (479) 631-9393

Other names 1

  • Lifetime Dental Doing business as

National Provider Directory

National Provider Directory

Locations

805 N 20th Pl
Ste 2
Rogers, AR 72756
Phone (479) 631-9393

Practitioners & affiliated clinicians

Practitioners 4

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": "1393545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1962827857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N 20TH PL STE 2",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727563571",
            "telephone_number": "479-631-9393",
            "fax_number": "479-986-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N 20TH PL STE 2",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727563571",
            "telephone_number": "479-631-9393",
            "fax_number": "479-986-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. TRENT GUBLER, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-28",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "GUBLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "TRENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-631-9393",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; 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.