ORAL SURGERY OF CENTRAL ARKANSAS (NPI# 1124491733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124491733 |
| Entity Type | Organization |
| Organization Name | ORAL SURGERY OF CENTRAL ARKANSAS |
| Practice Address |
2504 Mccain Blvd Ste 202 North Little Rock AR 72116-7612 |
| Practice Telephone | 5017717600 |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2015-11-04 |
| Authorized Official Name | DR. JOHN M JOHNSON (PRESIDENT) |
| Authorized Official Telephone | 5013275255 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
2606 | AR | Ambulatory Health Care Facilities |
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
3775 | AR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 200352679 | 05 | |
| AR | 202575679 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346612728 | Oral Surgery of Central Arkansas | Clinic/Center | 707 Parkway St Ste 103, Conway, AR 72034-5363 | 2015-10-26 |
| Street Address |
2504 MCCAIN BLVD STE 202 |
| City | NORTH LITTLE ROCK |
| State | AR |
| Zip Code | 72116-7612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710509997 | Dickerson Family Resource Center, LLC | Counselor | 5401 John F. Kennedy Blvd, Suite I Rm 1, North Little Rock, AR 72116 | 2020-05-11 |
| 1831609262 | Bill J Carpenter Sr. | Counselor | 4700 W Commercial Dr Ste B3, North Little Rock, AR 72116 | 2017-10-12 |
| 1992257646 | Meagan Booe | Behavioral Analyst | 3812 Lakewood Valley Drive, North Little Rock, AR 72116 | 2016-10-28 |
| 1295154300 | Min-ji Lee | Family Medicine | 2504 Mccain Blvd Ste 118, North Little Rock, AR 72116 | 2014-04-16 |
| 1255603486 | Crystal N Lackey | Physical Therapist | 3801 Jfk Blvd Ste C, North Little Rock, AR 72116 | 2012-02-03 |
| 1003055724 | North Little Rock, Pllc | Chiropractor | 4614 Jfk Blvd, North Little Rock, AR 72116 | 2009-02-19 |
| 1891933826 | Jennifer Ann Freilino | Counselor | 3805 Mccain Park Dr Ste 112, North Little Rock, AR 72116 | 2009-01-29 |
| 1679729669 | Amy Marie Jones | Speech-Language Pathologist | 5901 John F Kennedy Blvd Apt 5127, North Little Rock, AR 72116 | 2008-08-11 |
| 1992970917 | Ronald F Boyles Od Pa | Eyewear Supplier (Equipment, not the service) | 2520 Crestwood Road, North Little Rock, AR 72116 | 2008-04-30 |
| 1992976377 | Kencur Inc Statco Hearing Labs | Hearing Instrument Specialist | 4000 Mccain Blvd, Suite D, North Little Rock, AR 72116 | 2008-03-13 |
| Find all providers in zip 72116 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083842611 | Bryan Darling, Dds, Md, Pa | Clinic/Center | 317 Southwest Drive, Suite A, Jonesboro, AR 72401 | 2009-06-22 |
| 1922267657 | Modelevsky Dds Pa | Clinic/Center | 906 Osler Dr, Jonesboro, AR 72401-4366 | 2008-06-06 |
| 1174044952 | Dr. Stephen C. Fisher LLC | Clinic/Center | 1101 E Poplar St, Clarksville, AR 72830-4420 | 2017-06-30 |
| 1629438015 | Thomas A. Sarna, Dds Pllc | Clinic/Center | 2025 N Green Acres Rd, Fayetteville, AR 72703-2619 | 2016-02-29 |
| 1518325182 | Thomas A. Sarna Dds Pllc | Clinic/Center | 2411 Fayetteville Rd, Suite C, Van Buren, AR 72956-6520 | 2016-02-10 |
| 1508223827 | Thomas A. Sarna, Dds Pllc | Clinic/Center | 2025 N Green Acres Rd, Fayetteville, AR 72703-2619 | 2016-01-16 |
| 1346612728 | Oral Surgery of Central Arkansas | Clinic/Center | 707 Parkway St Ste 103, Conway, AR 72034-5363 | 2015-10-26 |
| 1518233691 | Mickey W. Lindsey D.d.s.,p.a. | Clinic/Center | 1920 W Washington St, Suite A, Camden, AR 71701-3134 | 2012-03-22 |
| 1841461274 | Arkansas Oral Surgery | Clinic/Center | 2425 Prince St, Suite 2, Conway, AR 72034-3746 | 2008-03-13 |
| City | NORTH LITTLE ROCK |
| Zip Code | 72116 |
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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.