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Deactivated NPI 1487646022 Deactivated / Inactive NPI Male Practitioner

Dr. Jerry Derek Ford , DDS

Dentist - General Practice • Gentry, AR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jerry Ford has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 19, 2005
NPI Deactivation Date March 23, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Jerry Ford, DDS was a registered Dentist - General Practice practicing in Gentry, AR. Throughout an active medical career spanning 1 years, Dr. Ford provided care at the practice location at 125 NORTH RUST AVE until profile deactivation on 2006-03-23.

Practice Location & Contact Primary Location

Practice Address

125 North Rust Ave

Gentry, AR 72734

Telephone 4797368789
Fax 4797365011
Associated Practice Facility / Clinic
🏢 Ford Dental Care Facility NPI 1124182142

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Gentry, AR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 25.0 Yrs
Regional Practice Density
3 Specialists

Practicing in Gentry, AR (909 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License AR 3095

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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Updated Practice Location July 08, 2007

Registered at 125 NORTH RUST AVE, GENTRY, AR 72734 (Tel: 4797368789)

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Updated Business Mailing Address July 08, 2007

Registered at PO BOX 1290, GENTRY, AR 727341290 (Tel: 4797368789)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JERRY FORD, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #3095 in AR)

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NPI Profile Reactivated April 10, 2006

Record officially reactivated for active practice on April 10, 2006

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NPI Profile Deactivated March 23, 2006

Record deactivated on March 23, 2006

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Initial NPI Registration & Enumeration August 19, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1487646022
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 19, 2005
Last Update: July 08, 2007
Deactivation Date: March 23, 2006
Sole Proprietor: No

Mailing Address

Po Box 1290

Gentry, AR 727341290

Phone: 4797368789

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.