Provider Demographics
NPI:1598979817
Name:ORSINI, JIM A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JIM
Middle Name:A
Last Name:ORSINI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:JIM
Other - Middle Name:A
Other - Last Name:ORSINI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5326 W MARKHAM ST
Mailing Address - Street 2:STE. 15
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3528
Mailing Address - Country:US
Mailing Address - Phone:501-664-6186
Mailing Address - Fax:501-664-6187
Practice Address - Street 1:5220 STUDER RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-9662
Practice Address - Country:US
Practice Address - Phone:501-690-1623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR24561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR208208627OtherEIN