COLLEGE STATION DENTAL
NPI 1073886156
Dentist - General Practice in College Station, AR
NPI Status: Active since February 20, 2012
Contact Information
4206 FRAZIER PIKE
COLLEGE STATION, AR
ZIP 72053
Phone: (501) 490-2440
Fax: (501) 490-0156
- Organization
- Dentist
- General Practice
- CLIA Number: 04D0466333
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 02-03-2027
About COLLEGE STATION DENTAL
This page provides the complete NPI Profile along with additional information for College Station Dental, a provider established in College Station, Arkansas operating as a Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1073886156 assigned on February 2012. The practitioner's primary taxonomy code is 1223G0001X. The provider is registered as an organization and their NPI record was last updated 14 years ago. College Station Dental operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as College Station Dental. The authorized official of this NPI record is Mr. Larnell W. Davis (Executive Director)
- NPI
- 1073886156
- Provider Legal Name
- JEFFERSON COMPREHENSIVE CARE SYSTEM, INC.
- Other Organization Name
- COLLEGE STATION DENTAL
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 4206 FRAZIER PIKE COLLEGE STATION, AR 72053
- Location Phone
- (501) 490-2440
- Location Fax
- (501) 490-0156
- Mailing Address
- PO BOX 1285 PINE BLUFF, AR 71613
- Mailing Phone
- (870) 536-5581
- Mailing Fax
- (501) 490-0156
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-20-2012
- Last Update Date
- 02-20-2012
- Code Navigator
A dentist like College Station Dental is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist General Practice
- Taxonomy Code
- 1223G0001X
- Type
- Dental Providers
- Taxonomy Description
- A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 56811 | OTHER (01) | AR | BLUE CROSS BLUE SHIELD |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 04D0466333
- Facility Type
- Community Clinic
- Certificate Effective Date
- February 04, 2025
- Certificate Expiration Date
- February 03, 2027
- Laboratory Director
- DR. MARCUS CROUTHER
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to College Station Dental in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1073886156, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
COLLEGE STATION, AR 72053
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073886156, enumerated as an "organization" on February 20, 2012.
The provider is located at 4206 FRAZIER PIKE COLLEGE STATION, AR 72053 and the phone number is (501) 490-2440.
Dentist with taxonomy code 1223G0001X and a focus in General Practice.
The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
