BETHEL BURRIS OLIVER PLLC (NPI# 1114260080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114260080 |
| Entity Type | Organization |
| Organization Name | BETHEL BURRIS OLIVER PLLC |
| Other Organization Name | ARKANSAS DENTISTRY AND BRACES |
| Practice Address |
1400 Se Walton Blvd Suite 42 Bentonville AR 72712-3722 |
| Mailing Address |
3782 N Front St Suite 1 Fayetteville AR 72703-5128 |
| Practice Telephone | 4792719944 |
| Practice Fax Number | 4792719945 |
| Mailing Telephone | 4794431705 |
| Mailing Fax Number | 4794431586 |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2015-03-03 |
| Authorized Official Name | BENJAMIN BURRIS (OWNER) |
| Authorized Official Telephone | 4794431705 |
| Authorized Official Credential | DDS, MDS, PA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
3339 | AR | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
3460 | AR | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
4013 | AR | Dental Providers |
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
3465 | AR | Dental Providers |
| Other Name | Type Code |
|---|---|
| Arkansas Dentistry and Braces | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952772592 | Bethel Burris Oliver Pllc | Dentist | 4901 Warden Rd, North Little Rock, AR 72116-7013 | 2015-10-08 |
| 1952772584 | Bethel Burris Oliver Pllc | Dentist | 401 S Bowman Rd, Little Rock, AR 72211-3452 | 2015-10-08 |
| 1801267430 | Bethel Burris Oliver Pllc | Dentist | 4224 W Sunset Ave, Springdale, AR 72762-4806 | 2015-10-08 |
| 1982071510 | Bethel Burris Oliver Pllc | Dentist | 2906 Cypress Rd, Arkadelphia, AR 71923-4227 | 2015-08-31 |
| 1982081592 | Bethel Burris Oliver Pllc | Dentist | 3245 E. Race St, Searcy, AR 72143 | 2015-05-04 |
| 1942694351 | Bethel Burris Oliver Pllc | Dentist | 3500 West Black Forest Drive, Fayetteville, AR 72704-5906 | 2015-03-24 |
| 1922498062 | Bethel Burris Oliver Pllc | Dentist | 3333 S Pinnacle Hills Pkwy, Rogers, AR 72758-9100 | 2015-01-28 |
| 1386048189 | Bethel Burris Oliver Pllc | Dentist | 2901 Zion Rd, Fayetteville, AR 72703-5007 | 2014-10-22 |
| 1700290194 | Bethel Burris Oliver Pllc | Dentist | 4803 E Johnson Ave, Jonesboro, AR 72401-8413 | 2014-06-13 |
| 1366883886 | Bethel Burris Oliver Pllc | Dentist | 3710 E Main St Ste J, Blytheville, AR 72315-6882 | 2013-07-12 |
| Street Address |
1400 SE WALTON BLVD SUITE 42 |
| City | BENTONVILLE |
| State | AR |
| Zip Code | 72712-3722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629232285 | Dennis J Mauro | Dentist | 1400 Se Walton Blvd, Suite 42, Bentonville, AR 72712-3722 | 2008-07-14 |
| 1023495074 | Bethel Burris Oliver Pllc | Dentist | 1400 Se Walton Blvd, Suite 10-12, Bentonville, AR 72712-3722 | 2015-04-29 |
| 1013329218 | Emily Mae Turner | Clinical Nurse Specialist | 1400 Se Walton Blvd, Bentonville, AR 72712-3722 | 2014-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427662345 | Bentonville Ambulatory Surgery Center, LLC | Pain Medicine | 2902 We Mid-cities Dr, Bentonville, AR 72712 | 2020-09-08 |
| 1942837059 | Amy Crumpton | Counselor | 3504 Se Riveria Road, Bentonville, AR 72712 | 2020-03-26 |
| 1295361509 | Unbridled Holdings LLC | Physical Therapy Assistant | 9900 Price Coffee Rd, Bentonville, AR 72712 | 2020-03-18 |
| 1649803552 | Hanna Kathryn Baxendale | Pediatrics | 2900 Medical Pkwy, Ste #370, Bentonville, AR 72712 | 2020-02-19 |
| 1740746635 | Meredith C Hodges | Counselor | 2508 Se 2oth St, Bentonville, AR 72712 | 2019-02-15 |
| 1609352566 | Tripharma Inc | Pharmacy | 3500 Sw Regional Airport Blvd Ste 2, Bentonville, AR 72712 | 2018-07-13 |
| 1811406747 | Upspring Therapy, LLC | Counselor | 2106 Sw Walton Blvd, Suite B, Bentonville, AR 72712 | 2017-09-22 |
| 1023536836 | Charlotte Yuvonne Hoyle | Case Manager/Care Coordinator | 2005 S.e Walton Blvd., Bentonville, AR 72712 | 2017-08-31 |
| 1508399502 | Rosanna Nicole Rephan | Nurse Practitioner | 3101 14th St, Mercy Convenient Care, Bentonville, AR 72712 | 2017-04-06 |
| 1417305517 | Charlotte Lennette Stephenson | Behavioral Analyst | 2005 S.e. Walton Blvd., Bentonville, AR 72712 | 2016-05-31 |
| Find all providers in zip 72712 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821605908 | Shannon Candid Arkansas, P.a. | Dentist | 900 Se 5th St Ste 22t, Bentonville, AR 72712-6090 | 2020-09-23 |
| 1629232285 | Dennis J Mauro | Dentist | 1400 Se Walton Blvd, Suite 42, Bentonville, AR 72712-3722 | 2008-07-14 |
| 1710032479 | Derek John Brown | Dentist | 1133 N Walton Blvd Ste A, Bentonville, AR 72712-4164 | 2007-01-24 |
| 1265596597 | Bill Pickard, D.d.s., M.s., P.a. | Dentist | 1400 Se Walton Blvd Ste 42, Bentonville, AR 72712-3202 | 2006-12-21 |
| 1457502791 | Derek John Brown Dmd, Ms, Pa | Dentist | 1133 N Walton Blvd Ste A, Bentonville, AR 72712-4164 | 2008-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982229985 | Kolin E. Weaver, Dds, Ms, Inc. | Dentist | 2316 Red Wolf Blvd Ste C, Jonesboro, AR 72401-6360 | 2020-06-15 |
| 1447875729 | Wardlaw Orthodontics, P.a. | Dentist | 8315 Cantrell Rd Ste 100, Little Rock, AR 72227-2354 | 2020-06-11 |
| 1659922904 | Hodge Orthodontics | Dentist | 2924 Kavanaugh Blvd, Little Rock, AR 72205-3719 | 2019-09-26 |
| 1700346772 | Ashcraft Orthodontics Pllc | Dentist | 23 Shackleford Dr Ste A, Little Rock, AR 72211-2990 | 2019-03-25 |
| 1518434398 | Michelle Lien Clinton Munoz | Dentist | 1917 Reveille Cir, Jacksonville, AR 72076-9157 | 2018-10-30 |
| 1376057562 | Freeman Mobile Orthodontics, Pllc | Dentist | 803 Quandt Ave, Springdale, AR 72764-5352 | 2017-11-27 |
| 1265954432 | David Bell | Dentist | 1455 Harrison St, Batesville, AR 72501-7220 | 2017-07-10 |
| 1467984716 | Axpm-harrison Pllc | Dentist | 303 Eureka Ave, Berryville, AR 72616-3833 | 2017-03-28 |
| 1740720101 | Clayton L Owen Dds, Pa | Dentist | 1306 S Pine St, Cabot, AR 72023-3812 | 2017-03-06 |
| 1578001616 | Jesse R Gray Dds Pa | Dentist | 3119 E Mission Blvd, Fayetteville, AR 72703-6617 | 2017-02-09 |
| Find all providers with the same taxonomy | ||||
| City | BENTONVILLE |
| Zip Code | 72712 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.