Healthcare Provider Details

I. General information

NPI: 1356668826
Provider Name (Legal Business Name): KAY AMIN CASHMAN DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 10/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 E LONGVIEW ST
FAYETTEVILLE AR
72703-4618
US

IV. Provider business mailing address

PO BOX 9390
FAYETTEVILLE AR
72703-0023
US

V. Phone/Fax

Practice location:
  • Phone: 479-527-2763
  • Fax: 479-442-4557
Mailing address:
  • Phone: 479-717-1171
  • Fax: 877-900-2896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number3409
License Number StateAR

VIII. Authorized Official

Name: DR. KAY AMIN CASHMAN
Title or Position: OWNER
Credential: DDS
Phone: 479-527-2763