NPIMap

Organization Active NPI

Main Street Dental PLLC

  • Dental Clinic/Center
  • Bentonville, AR
National Provider Identifier
1972930295
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
3599 Issued in AR
Legal business name
MAIN STREET DENTAL PLLC
Practice address
312 S Main St
Bentonville, AR 72712-5903
Phone
(479) 254-6899
Fax
(479) 254-6749
NPI assigned
Oct 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Authorized official

Name
Benjamin D. Hall, DDSNPI 1447391297
Title
Member/Manager
Phone
(479) 254-6899

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 3599 AR Primary

Addresses

Primary practice location

312 S Main St
Bentonville, AR 72712-5903

Mailing address

312 S Main St
Bentonville, AR 72712-5903
Phone (479) 254-6899

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380585600000",
    "number": "1972930295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 S MAIN ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727125903",
            "telephone_number": "479-254-6899",
            "fax_number": "479-254-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 S MAIN ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727125903",
            "telephone_number": "479-254-6899",
            "fax_number": "479-254-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "479-254-6899",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AR",
            "license": "3599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.