Provider Demographics
NPI:1386993525
Name:DIXON, WILLIAM KYLE (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:KYLE
Last Name:DIXON
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 1:4137 SAVANNAH LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-7865
Mailing Address - Country:US
Mailing Address - Phone:479-970-8449
Mailing Address - Fax:
Practice Address - Street 1:3617 W SUNSET AVE
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-4955
Practice Address - Country:US
Practice Address - Phone:479-970-8449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK74061223G0001X
AR38831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice