NORTHWEST ARKANSAS PERIODONTAL ASSOCIATES, PLLC
NPI 1053418038
Dentist - Periodontics in Fayetteville, AR

Q: What is Northwest Arkansas Periodontal Associates, PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Active since September 20, 2006

1831 N GREEN ACRES RD, FAYETTEVILLE, AR 72703(479) 521-6400(479) 521-0164 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Northwest Arkansas Periodontal Associates, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHWEST ARKANSAS PERIODONTAL ASSOCIATES, PLLC (NPI 1053418038) is a healthcare organization registered as a periodontics in Fayetteville, Arkansas and active in the NPI registry since September 2006. The organization lists Gary Renegar, Member, as its authorized official.

NPPES Registry Identity

NPI1053418038

Entity TypeOrganization

Primary Taxonomy1223P0300X

Legal Business NameNORTHWEST ARKANSAS PERIODONTAL ASSOCIATES, PLLC

Location Address1831 N GREEN ACRES RDFayetteville, AR 72703-2615

Mailing Address1831 N Green Acres RdFayetteville, AR 72703-2615 · (479) 521-6400 · Fax (479) 521-0164

Phone(479) 521-6400

Fax(479) 521-0164

Organization SubpartNo

Authorized OfficialGary RenegarMember · (479) 521-6400

Enumeration DateSeptember 20, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1053418038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

1831 N GREEN ACRES RD, Fayetteville, AR 72703

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Other Identifiers 1

Other58605AR · Blue Cross Blue Shield

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JAMES CHARLES TINNIN D.D.S.

Dentist (Endodontics)