BETHEL BURRIS OLIVER PLLC (NPI# 1942694351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942694351 |
| Entity Type | Organization |
| Organization Name | BETHEL BURRIS OLIVER PLLC |
| Other Organization Name | ARKANSAS DENTISTRY AND BRACES |
| Practice Address |
3500 West Black Forest Drive Fayetteville AR 72704-5906 |
| Mailing Address |
3782 N Front St Ste 1 Fayetteville AR 72703-5906 |
| Practice Telephone | 4794456335 |
| Mailing Telephone | 4794456335 |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2015-07-17 |
| Authorized Official Name | DR. BENJAMIN G BURRIS (OWNER) |
| Authorized Official Telephone | 4794456335 |
| 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 |
Dental Providers | ||
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers | ||
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
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 |
| 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 |
| 1801237326 | Bethel Burris Oliver Pllc | Dentist | 4941 N Washington St, Forrest City, AR 72335-7723 | 2013-07-12 |
| Street Address |
3500 WEST BLACK FOREST DRIVE |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72704-5906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598387037 | Anne-ashley Hull | Speech-Language Pathologist | 12905 Randolph Road, Fayetteville, AR 72704 | 2020-05-07 |
| 1427607019 | Destiny Bound, LLC | Midwife | 3825 N Salem Road, Fayetteville, AR 72704 | 2019-09-06 |
| 1043796881 | Travis Alexander | Physical Therapist | 3399 Black Forest Dr Ste 3, Fayetteville, AR 72704 | 2018-07-16 |
| 1104319433 | Rise Physical Therapy Pa | Clinic/Center | 3484 W Wedington Dr Ste 4, Fayetteville, AR 72704 | 2018-06-12 |
| 1346744232 | Wedington Dental, Pllc | Clinic/Center | 3500 Black Forest Drvie, Ste 1, Fayetteville, AR 72704 | 2018-03-23 |
| 1528410487 | Sharon Byrd | Licensed Practical Nurse | 17836 Harmon Rd, Fayetteville, AR 72704 | 2016-07-05 |
| 1861823502 | Andrea Warren | Pharmacist | 2875 W Martin Luther King Jr Blvd, Fayetteville, AR 72704 | 2013-12-05 |
| 1609157726 | Jessica Rose Collier | Speech-Language Pathologist | 2020 E Joyce Ave., Suite 2, Fayetteville, AR 72704 | 2011-09-02 |
| 1194044941 | Wcnc, Inc. | Skilled Nursing Facility | 4405 Persimmon Street, Fayetteville, AR 72704 | 2010-05-19 |
| 1841512944 | Jill K Johnston | Speech-Language Pathologist | 3472 N Sandpiper Dr, Fayetteville, AR 72704 | 2010-02-17 |
| Find all providers in zip 72704 | ||||
| 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 |
|---|---|---|---|---|
| 1578001616 | Jesse R Gray Dds Pa | Dentist | 3119 E Mission Blvd, Fayetteville, AR 72703-6617 | 2017-02-09 |
| 1972972685 | Trinity Orthodontics of Fayetteville LLC | Dentist | 719 Lanier Ave W Ste B, Fayetteville, GA 30214-7621 | 2015-09-23 |
| 1386048189 | Bethel Burris Oliver Pllc | Dentist | 2901 Zion Rd, Fayetteville, AR 72703-5007 | 2014-10-22 |
| 1083957351 | Gateway Ventures LLC | Dentist | 3782 N Front St, Suite 1, Fayetteville, AR 72703-5128 | 2013-04-04 |
| 1780995449 | Gregory J Stock | Dentist | 404 E Genesee St, Fayetteville, NY 13066-1503 | 2010-06-28 |
| 1003019845 | Dana Thi Tang | Dentist | 2997 Hope Mills Rd Ste C, Fayetteville, NC 28306-8349 | 2007-06-08 |
| 1326256066 | Eric J. Echols | Dentist | 102 Pavilion Pkwy, Suite 14, Fayetteville, GA 30214-4056 | 2007-05-18 |
| 1033325436 | Darrin Storms D.d.s., C.a.g.s., P.a. | Dentist | 4102 N Mall Ave Ste 101, Fayetteville, AR 72703-4929 | 2007-05-15 |
| 1962623819 | J. Spencer Boley | Dentist | 4501 W Wedge Dr, Fayetteville, AR 72704-7532 | 2007-05-01 |
| 1992864375 | Michael W Granger | Dentist | 745 Bradley Dr, Fayetteville, GA 30214-2030 | 2006-12-08 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72704 |
Please comment or provide details below to improve the information on BETHEL BURRIS OLIVER PLLC.
| 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.