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PREMIER DERMATOLOGY & SKIN RENEWAL CENTER
NPI 1912912361
Dermatology - Clinical & Laboratory Dermatological Immunology in Bentonville, AR

Active since July 31, 2006
909 SE 28TH ST, STE 5, BENTONVILLE, AR 72712(479) 273-3376(479) 273-3468 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Premier Dermatology & Skin Renewal Center NPPES

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

PREMIER DERMATOLOGY & SKIN RENEWAL CENTER (NPI 1912912361) is a healthcare organization registered as a clinical & laboratory dermatological immunology in Bentonville, Arkansas and active in the NPI registry since July 2006. The organization lists Jeff Clifton, Coo, as its authorized official.

NPPES Registry Identity

NPI1912912361
Entity TypeOrganization
Primary Taxonomy207NI0002X
Legal Business NamePREMIER DERMATOLOGY & SKIN RENEWAL CENTER
Location Address909 SE 28TH ST, STE 5Bentonville, AR 72712-3880
Mailing Address909 Se 28th St, Ste 5Bentonville, AR 72712-3880 · (479) 273-3376 · Fax (479) 273-3468
Phone(479) 273-3376
Fax(479) 273-3468
Organization SubpartNo
Authorized OfficialJeff CliftonCoo · (479) 273-3376
Enumeration DateJuly 31, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1912912361 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatology · Clinical & Laboratory Dermatological ImmunologyAllopathic & Osteopathic Physicians
Taxonomy Code207NI0002X
Definition
A dermatologist who utilizes various specialized laboratory procedures to diagnose disorders characterized by defective responses of the body's immune system. Immunodermatologists also may provide consultation in the management of these disorders and administer specialized forms of therapy for these diseases.
Also ListedDermatologyTaxonomy 207N00000X · License E3363 (AR)
Also ListedDermatology · Pediatric DermatologyTaxonomy 207NP0225X · License E3363 (AR)
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X · License E3363 (AR)

Other Identifiers 2

Other1679521405AR · Npi - Mildred Clifton, Md
Other03060015000AR · Qualchoice

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 MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

ADVANCED AESTHETICS & WELLNESS CENTER PA, EARLMD FAMILY MEDICINE PA
Family Medicine
909 SE 28TH ST, SUITE 9
BENTONVILLE, AR 72712
Benton County (479) 273-1426

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 Premier Dermatology & Skin Renewal Center's NPI number?

The NPI number for Premier Dermatology & Skin Renewal Center is 1912912361. It was assigned to this organization in the NPPES registry on July 31, 2006.

Where is Premier Dermatology & Skin Renewal Center located?

Premier Dermatology & Skin Renewal Center is located at 909 SE 28th St Ste 5, Bentonville, AR 72712. The listed phone number is (479) 273-3376.

What is Premier Dermatology & Skin Renewal Center's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Clinical & Laboratory Dermatological Immunology, with taxonomy code 207NI0002X.

When was this NPI record last updated?

The NPPES record for Premier Dermatology & Skin Renewal Center was last updated on September 11, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.