Healthcare Provider Details

I. General information

NPI: 1366015349
Provider Name (Legal Business Name): KAYLA M. GOODSON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA M. PAYNE DDS

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4039 CENTRAL AVE # B
HOT SPRINGS AR
71913-7208
US

IV. Provider business mailing address

PO BOX 1848
MENA AR
71953-1841
US

V. Phone/Fax

Practice location:
  • Phone: 501-623-7113
  • Fax:
Mailing address:
  • Phone: 888-710-8220
  • Fax: 866-573-0761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4531
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: