Provider Demographics
NPI:1972063386
Name:SPEARMAN, REBECCA LYNN (DDS)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:SPEARMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LYNN
Other - Last Name:MACKIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 RED OAK PL
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-6805
Mailing Address - Country:US
Mailing Address - Phone:479-886-5526
Mailing Address - Fax:
Practice Address - Street 1:2235 DAVE WARD DR STE 103
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-7040
Practice Address - Country:US
Practice Address - Phone:501-932-0192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-21
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR44251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice