Healthcare Provider Details

I. General information

NPI: 1699785923
Provider Name (Legal Business Name): BEVANS CHILDREN'S DENTISTRY, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S RODNEY PARHAM RD SUITE 3
LITTLE ROCK AR
72205-4747
US

IV. Provider business mailing address

300 S RODNEY PARHAM RD SUITE 3
LITTLE ROCK AR
72205-4747
US

V. Phone/Fax

Practice location:
  • Phone: 501-224-4799
  • Fax: 501-224-9278
Mailing address:
  • Phone: 501-224-4799
  • Fax: 501-224-9278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3542
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number1833
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3555
License Number StateAR

VIII. Authorized Official

Name: DR. JAMES L. BEVANS
Title or Position: PRESIDENT
Credential: D.D.S., M.S.
Phone: 501-224-4799