1801090295 NPI number — BILLY R MACHEN DDS

Table of content: (NPI 1801090295)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801090295 NPI number — BILLY R MACHEN DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BILLY R MACHEN DDS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1801090295
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4220 N RODNEY PARHAM RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
LITTLE ROCK
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72212-2453
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-954-9900
Provider Business Mailing Address Fax Number:
501-661-0066

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4220 N RODNEY PARHAM RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72212-2453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-954-9900
Provider Business Practice Location Address Fax Number:
501-661-0066
Provider Enumeration Date:
06/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BROWNING
Authorized Official First Name:
T
Authorized Official Middle Name:
Authorized Official Title or Position:
INSURANCE SPECIALIST
Authorized Official Telephone Number:
501-954-9900

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DAR2779 , 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)

  • Identifier: 1457426991 . This is a "BILLY R MACHEN DDS" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 1568590099 . This is a "JOHN SCOTT SCALLION" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 1801924345 . This is a "ROBIN G EILER DDS" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 1548397029 . This is a "DANIEL BEENE DDS" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".




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