1598801268 NPI number — DR. ANDREA M. DENSON-MEANS M.S., D.M.D.

Table of content: DR. ANDREA M. DENSON-MEANS M.S., D.M.D. (NPI 1598801268)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598801268 NPI number — DR. ANDREA M. DENSON-MEANS M.S., D.M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DENSON-MEANS
Provider First Name:
ANDREA
Provider Middle Name:
M.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.S., D.M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598801268
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/18/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 999
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORREST CITY
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72336-0999
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-242-7543
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
420 E COOK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORREST CITY
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72335-2869
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-633-4894
Provider Business Practice Location Address Fax Number:
870-633-4965
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  012050 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: 3557 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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