Kirby L Davenport, DDS is a
Dentist - General Practice based in Bull Shoals, Arkansas. Kirby L Davenport is licensed to practice in Arkansas (license number 2230) and his current practice location is
Highway 178 & 508 Hillcrest, Bull Shoals, Arkansas. He can be reached at his office (for appointments etc.) via phone at
(870) 445-4040.
NPI number for Kirby L Davenport is 1619912896 and his current mailing address is Po Box 717, Bull Shoals, Arkansas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1619912896.
Healthcare Provider's Profile
| Full Name | Kirby L Davenport |
|---|
| Gender | Male |
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| Speciality | Dentist - General Practice |
|---|
| Location | Highway 178 & 508 Hillcrest, Bull Shoals, Arkansas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1619912896
- Provider Enumeration Date: 06/19/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Kirby L Davenport such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619912896 | NPI | - | NPPES |
| 108534 | Other | AR | UNITED CONCORDIA |
| 58699 | Other | AR | BLUE CROSS BLUE SHIELD |
| 91028000040 | Other | AR | QUAL CHOICE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 2230 (Arkansas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kirby L Davenport is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kirby L Davenport, DDS
Po Box 717,
Bull Shoals, AR 72619-0717
Ph: (870) 445-4040 | Kirby L Davenport, DDS
Highway 178 & 508 Hillcrest,
Bull Shoals, AR 72619
Ph: (870) 445-4040 |
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