Provider Demographics
NPI:1538507058
Name:STROOPE, BRITTANY ILENE (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:ILENE
Last Name:STROOPE
Suffix:
Gender:F
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 W HUNTSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-7723
Mailing Address - Country:US
Mailing Address - Phone:501-617-4017
Mailing Address - Fax:
Practice Address - Street 1:2709 W HUNTSVILLE AVE
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-7723
Practice Address - Country:US
Practice Address - Phone:501-617-4017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR37661223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR198007608Medicaid