Provider Demographics
NPI:1346464385
Name:ARNOLD, DARNELL SAMUEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARNELL
Middle Name:SAMUEL
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5608 MANOR RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-4731
Mailing Address - Country:US
Mailing Address - Phone:512-928-4390
Mailing Address - Fax:512-928-1834
Practice Address - Street 1:5608 MANOR RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-4731
Practice Address - Country:US
Practice Address - Phone:512-928-4390
Practice Address - Fax:512-928-1834
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB10792-01OtherTEXAS CHIPS (DELTA DENTAL
TX00BB70OtherBCBSTX