Southern Dental of Brunswick PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3930 Issued in AR

Legal business name

SOUTHERN DENTAL OF BRUNSWICK PLLC

Practice address

8755 Chaffee Road
Suite 103
Arlington, TN 38002

Phone

(901) 382-9704

NPI assigned

Nov 13, 2017

Last updated

Nov 13, 2017By 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

Dr. William Reynolds Little, DDS

Title

Owner

Phone

(870) 243-4406

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510531200000",
    "number": "1962915959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17151",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724036720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8755 CHAFFEE ROAD",
            "address_2": "SUITE 103",
            "city": "ARLINGTON",
            "state": "TN",
            "postal_code": "38002",
            "telephone_number": "901-382-9704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DENTAL OF BRUNSWICK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2017-11-13",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "REYNOLDS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-243-4406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Arlington, TN
• Providers in Arlington, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.