Jack Reid Fawcett, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4591 Issued in AR

Practice address

82 Southwinds Rd
Farmington, AR 72730-8677

Phone

(479) 267-2266

Fax

(479) 267-4880

NPI assigned

May 26, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Legacy Dental

  • General Practice Dentistry
  • Rogers, AR
  • NPI 1528853934
  NPD Authorized official
• River Dental Farmington, PLLC

  • General Practice Dentistry
  • Farmington, AR
  • NPI 1447792759
  NPD
• Anthony J Greenwood, DDS, LLC

  • Dental Clinic/Center
  • Baxter Springs, KS
  • NPI 1336537786
  NPD (past)
• Baxter Springs Family Dentistry PA

  • Dentist
  • Baxter Springs, KS
  • NPI 1326621558
  NPD (past)

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1972241164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6791 GARDEN TRAIL AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727627048",
            "telephone_number": "501-412-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 SOUTHWINDS RD",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727308677",
            "telephone_number": "479-267-2266",
            "fax_number": "479-267-4880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1440 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Baxter Springs",
            "state": "KS",
            "postal_code": "667132727",
            "country_code": "US",
            "telephone_number": "620-856-2173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAWCETT",
        "first_name": "JACK",
        "middle_name": "REID",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-26",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "4591",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "62432",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Estes
• Samantha Renee Evans, M.S. SLP
• Exceed Physical Therapy, Inc.
• Faith Works on the Spectrum, LLC
• Farmington Family Medical LLC
• Kim Ferguson, LAC
• Lula Camille Ferguson
• Jill Flood
• Brooke Flumm
• Foundational Futures PLLC

• General Practice Dentistry in Farmington, AR
• Providers in Farmington, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.