Provider Demographics
NPI:1184210296
Name:BRANDON R STROOPE. DMD. PLLC
Entity Type:Organization
Organization Name:BRANDON R STROOPE. DMD. PLLC
Other - Org Name:STROOPE DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:STROOPE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:501-844-5505
Mailing Address - Street 1:3860 HIGHWAY 412 E
Mailing Address - Street 2:SUITE F
Mailing Address - City:SILOAM
Mailing Address - State:AR
Mailing Address - Zip Code:72761-8499
Mailing Address - Country:US
Mailing Address - Phone:479-306-6433
Mailing Address - Fax:479-524-0976
Practice Address - Street 1:3860 HIGHWAY 412 E
Practice Address - Street 2:SUITE F
Practice Address - City:SILOAM
Practice Address - State:AR
Practice Address - Zip Code:72761-8499
Practice Address - Country:US
Practice Address - Phone:479-306-6433
Practice Address - Fax:479-524-0976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-14
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR191410608Medicaid