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NPI Code Detail

MEDICARE: CANTRELL DENTAL

MEDICARE: CANTRELL DENTAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821567389
Entity Type Code : Organization
Provider Name (Legal Business Name) : CANTRELL DENTAL
Provider Business Mailing Address
First Line : 14923 CANTRELL RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72223-4255
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 14923 CANTRELL RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72223-4255
Country : US
Telephone Number : 501-690-3468
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : SAMIR SULIEMAN
Credential : DDS
Telephone Number : 501-690-3468
Provider Enumeration Date : 11/14/2018
Last Update Date : 11/14/2018

Similar Medicare Providers

1639869753 — EASTERSEALS ARKANSAS
Practice Location Address:
14901 CANTRELL RD
LITTLE ROCK, AR
72223-4255
Practice Phone: 501-367-1200
Practice Fax:
1811369929 — ALYSSA STATON M.S., CCC-SLP
Practice Location Address:
14901 CANTRELL RD
LITTLE ROCK, AR
72223-4255
Practice Phone: 501-367-1200
Practice Fax:
1225764368 — ASHLEY SUE JENSON CCC-SLP
Practice Location Address:
14901 CANTRELL RD
LITTLE ROCK, AR
72223-4255
Practice Phone: 501-821-5459
Practice Fax:
1386355089 — MRS. TRACEY JO GUSTAVESON RN
Practice Location Address:
14901 CANTRELL RD
LITTLE ROCK, AR
72223-4255
Practice Phone: 501-367-1200
Practice Fax:
1477352599 — MR. FRANK H BREGY III OTR/L
Practice Location Address:
14901 CANTRELL RD
LITTLE ROCK, AR
72223-4255
Practice Phone: 501-227-3600
Practice Fax:
1457210205 — TREVOR OVERBAY
Practice Location Address:
12911 CANTRELL RD STE 4
LITTLE ROCK, AR
72223-1710
Practice Phone: 501-224-1224
Practice Fax:

Directions to “CANTRELL DENTAL ” Practice Location

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