1. Home
  2. Directory
  3. Arkansas
  4. Jonesboro
  5. Dentist
  6. NPI Profile

NORTHEAST ARKANSAS OMFS, PLLC
NPI 1427700111
Dentist - Oral and Maxillofacial Surgery in Jonesboro, AR

Active since January 24, 2022CLIA 04D1075413 · Waiver
2609 BROWNS LN, JONESBORO, AR 72401(870) 931-3000(870) 931-0190 Get Directions Write a Review

NPPES record last updated: January 24, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Northeast Arkansas Omfs, Pllc NPPES

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

NORTHEAST ARKANSAS OMFS, PLLC (NPI 1427700111) is a healthcare organization registered as an oral and maxillofacial surgery in Jonesboro, Arkansas and active in the NPI registry since January 2022. The organization holds a CLIA Waiver certificate valid through October 18, 2027 and lists Matthew L Mcdonough, Ceo, as its authorized official.

NPPES Registry Identity

NPI1427700111
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameNORTHEAST ARKANSAS OMFS, PLLC
Location Address2609 BROWNS LNJonesboro, AR 72401-7227
Mailing Address2609 Browns LnJonesboro, AR 72401-7227 · (870) 931-3000 · Fax (870) 931-0190
Phone(870) 931-3000
Fax(870) 931-0190
Organization SubpartNo
Authorized OfficialMatthew L McdonoughCeo · (870) 931-3000
Enumeration DateJanuary 24, 2022
NPPES CertifiedJanuary 24, 2022
✔ NPI 1427700111 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
2609 BROWNS LN, Jonesboro, AR 72401
Open in Google Maps ↗

Other Identifiers 1

Medicaid225890679AR

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D1075413

Northeast Arkansas Omfs, PLLC · Jonesboro, AR
Active · expires Oct 18, 2027
CLIA Number04D1075413
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateOctober 19, 2025
Certificate Expiration DateOctober 18, 2027
Laboratory DirectorDr. Matthew L. Mcdonough
Laboratory Phone(870) 931-3000
Laboratory LocationNortheast Arkansas Omfs, PLLC2609 Browns Lane, Jonesboro, AR 72401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

JAMES B PHILLIPS, MS, DDS, PA
Clinic/Center (Dental)
2609 BROWNS LN
JONESBORO, AR 72401
Craighead County (870) 931-3000
JAMES B PHILLIPS D.D.S.
Dentist (Oral and Maxillofacial Surgery)
2609 BROWNS LN
JONESBORO, AR 72401
Craighead County (870) 931-3000
JAMES B. PHILLIPS MS DDS PA
Dentist (Oral and Maxillofacial Surgery)
2609 BROWNS LN
JONESBORO, AR 72401
Craighead County (870) 931-3000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northeast Arkansas Omfs, PLLC's NPI number?

The NPI number for Northeast Arkansas Omfs, PLLC is 1427700111. It was assigned to this organization in the NPPES registry on January 24, 2022.

Where is Northeast Arkansas Omfs, PLLC located?

Northeast Arkansas Omfs, PLLC is located at 2609 Browns Ln, Jonesboro, AR 72401. The listed phone number is (870) 931-3000.

What is Northeast Arkansas Omfs, PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Does Northeast Arkansas Omfs, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D1075413) is associated with this NPI, valid through October 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Northeast Arkansas Omfs, PLLC was last updated on January 24, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.