Provider Demographics
NPI:1841691912
Name:DOUGLAS RINEHART, DDS, P.A.
Entity type:Organization
Organization Name:DOUGLAS RINEHART, DDS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RINEHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-219-9159
Mailing Address - Street 1:911 N WALTON BLVD
Mailing Address - Street 2:STE. B
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4551
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:911 N WALTON BLVD
Practice Address - Street 2:STE. B
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4551
Practice Address - Country:US
Practice Address - Phone:479-464-7500
Practice Address - Fax:479-273-7741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3879122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1033472535OtherTYPE I NPI
AR3879OtherAR DENTAL LICENSE