ARKANSAS ORTHODONTIC CENTER (NPI# 1740449339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740449339 |
| Entity Type | Organization |
| Organization Name | ARKANSAS ORTHODONTIC CENTER |
| Practice Address |
3409 Gateway Cove Jonesboro AR 72404 |
| Practice Telephone | 8709720460 |
| Mailing Telephone | 8709720460 |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-08-19 |
| Authorized Official Name | DR. BENJAMIN GRAY BURRIS (ORTHODONTIST) |
| Authorized Official Telephone | 8709728249 |
| Authorized Official Credential | DDS MDS PA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
3465 | AR | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 167957631 | 05 |
| Street Address |
3409 GATEWAY COVE |
| City | JONESBORO |
| State | AR |
| Zip Code | 72404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558538181 | Arkansas Dental Clinic | Dentist | 3409 Gateway Cove, Jonesboro, AR 72404 | 2008-05-13 |
| 1205099975 | Lucy Digmon | Dentist | 3409 Gateway Cove, Jonesboro, AR 72404 | 2008-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740745967 | Imove, LLC | Physical Therapist | 8700 S. Caraway Rd., Apt. L2, Jonesboro, AR 72404 | 2019-02-01 |
| 1245728914 | Karina Coats | Nurse Anesthetist, Certified Registered | 2409 Skyline Pt, Jonesboro, AR 72404 | 2018-04-27 |
| 1619325263 | Kathryn Meyers | Specialist/Technologist | 1614 Latourette Ln Apt 2, Jonesboro, AR 72404 | 2016-05-24 |
| 1922476571 | Tmj and Facial Pain Center,llc | Dentist | 2600 Browns Lane, Ste B, Jonesboro, AR 72404 | 2015-09-11 |
| 1265828156 | Hd Dental, Pa Dba Smile Dental | Dentist | 6009 Highway 1 South, Jonesboro, AR 72404 | 2015-04-08 |
| 1124445358 | Tanner Wilson Jarrett | Occupational Therapy Assistant | 3114 Fox Road Suite A, Jonesboro, AR 72404 | 2014-03-26 |
| 1154759793 | Kasey Boyd | Specialist/Technologist | 1717 Hwy 163, Jonesboro, AR 72404 | 2013-10-17 |
| 1578848610 | Maria Ivonne Norman | Physical Therapist | 8700 S. Caraway Rd. Apt. L2, (the Meadows), Jonesboro, AR 72404 | 2011-10-20 |
| 1003198839 | Rachel Hollimon Golden | Speech-Language Pathologist | 4410 Harrisburg Rd., Jonesboro, AR 72404 | 2011-09-19 |
| 1225358021 | Darrell R Gann | Physical Therapy Assistant | 6040 Beaver Creek, Jonesboro, AR 72404 | 2010-06-03 |
| Find all providers in zip 72404 | ||||
| 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 |
|---|---|---|---|---|
| 1982229985 | Kolin E. Weaver, Dds, Ms, Inc. | Dentist | 2316 Red Wolf Blvd Ste C, Jonesboro, AR 72401-6360 | 2020-06-15 |
| 1043681448 | Axpm Jonesboro, Pllc | Dentist | 2316 Red Wolf Blvd, Suite C, Jonesboro, AR 72401-0000 | 2015-10-12 |
| 1700290194 | Bethel Burris Oliver Pllc | Dentist | 4803 E Johnson Ave, Jonesboro, AR 72401-8413 | 2014-06-13 |
| 1003194317 | Fergus Orthodontics Pllc | Dentist | 801 Osler Drive, Suite D, Jonesboro, AR 72401 | 2011-08-03 |
| 1457649220 | Bufford Suffridge | Dentist | 2606 Browns Ln, Jonesboro, AR 72401-7226 | 2011-07-14 |
| 1093979254 | Kelly-gwynne Mason Fergus | Dentist | 2812 Harrisburg Rd, Jonesboro, AR 72401-6081 | 2008-07-16 |
| 1942471271 | Kolin Emrys Weaver | Dentist | 2605 Browns Ln, Jonesboro, AR 72401-7227 | 2008-03-14 |
| 1184727315 | T Scott Allen Dds Ms | Dentist | 910 Professional Acres Dr, Jonesboro, AR 72401-4321 | 2006-09-06 |
| 1932756608 | Savanah L Stewart | Dentist | 2605 Browns Ln, Jonesboro, AR 72401-7227 | 2019-08-19 |
| 1285049288 | John Stephen Boling | Dentist | 2606 Browns Ln, Jonesboro, AR 72401-7226 | 2014-06-27 |
| Find all providers in JONESBORO | ||||
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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.