Active NPI
Bruce Lane Welsh, DDS
- Dentist
- Fayetteville, AR
National Provider Identifier
1982772018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2608
- Practice address
- 745 E. Joyce
Suite 221
Fayetteville, AR 72703 - Phone
- (479) 443-1849
- Fax
- (479) 443-2034
- NPI assigned
- Nov 30, 2006
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2608 | AR | Primary |
Addresses
Primary practice location
745 E. Joyce
Suite 221
Fayetteville, AR 72703
Mailing address
406 S East Ave
Fayetteville, AR 72701-6046
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 71-0764541 | Medicaid | AR |
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 |
|---|---|---|---|
| 2608 | AR | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256860800000",
"number": "1982772018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "406 S EAST AVE",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727016046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "745 E. JOYCE",
"address_2": "SUITE 221",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "72703",
"telephone_number": "479-443-1849",
"fax_number": "479-443-2034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELSH",
"first_name": "BRUCE",
"middle_name": "LANE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2009-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "2608",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "71-0764541",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.