BRAD WHEELIS FAMILY DENTISTRY PLLC NPI 1275143950

Clinic/Center (Dental) in Melbourne, AR

NPI 1275143950 Organization Clinic/Center Dental

About BRAD WHEELIS FAMILY DENTISTRY PLLC

Brad Wheelis Family Dentistry Pllc is a provider established in Melbourne, Arkansas specializing in clinic/center (dental) . The NPI number of Brad Wheelis Family Dentistry Pllc is 1275143950 and was assigned on August 2020. The practitioner's primary taxonomy code is 261QD0000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Dr. Brad Wheelis Dds (Owner)

NPI

1275143950

Provider NameBRAD WHEELIS FAMILY DENTISTRY PLLC
Provider Location Address1218 EAST MAIN ST MELBOURNE, AR 72556
Provider Mailing AddressPO BOX 1074 MELBOURNE, AR 72556
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date08-06-2020
Last Update Date08-06-2020


Primary Taxonomy

Taxonomy Code261QD0000X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationDental

Business Address

BRAD WHEELIS FAMILY DENTISTRY PLLC
1218 EAST MAIN ST
MELBOURNE, AR
ZIP 72556
Phone: (870) 368-5551
Fax: (870) 368-5554

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Mailing Address

BRAD WHEELIS FAMILY DENTISTRY PLLC
PO BOX 1074
MELBOURNE, AR
ZIP 72556
Phone: (870) 368-5551
Fax: (870) 368-5554



Authorized Official

Authorized Official NameDR. BRAD WHEELIS DDS
Authorized Official TitleOWNER
Authorized Official Phone(870) 368-5551

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.