Premier Dermatology & Skin Renewal Center

Organization Active
NPI 1912912361
Clinical & Laboratory Dermatological Immunology Physician Bentonville, AR

Premier Dermatology & Skin Renewal Center is a clinical & laboratory dermatological immunology physician located in Bentonville, AR. The NPI was issued on July 31, 2006, and the record was last updated in NPPES on September 11, 2025. The record lists 4 taxonomy codes.

Taxonomies and licenses

TaxonomyCodeLicense
Clinical & Laboratory Dermatological Immunology Physician Primary 207NI0002X (AR)
Dermatology Physician 207N00000X E3363 (AR)
Pediatric Dermatology Physician 207NP0225X E3363 (AR)
Procedural Dermatology Physician 207NS0135X E3363 (AR)

Practice location

909 SE 28th St
Ste 5
Bentonville, AR 72712-3880
Phone: (479) 273-3376

Local context

Active NPPES records list 1 provider with clinical & laboratory dermatological immunology physician as the primary taxonomy within 25 miles of this practice location's ZIP code.

The same primary taxonomy is listed by 1 in Arkansas and 95 nationwide.

These are counts from NPPES records, not a ranking or recommendation. Distances are measured between ZIP code centers, not street addresses.

Record history

Status
Active
NPI issued
Last updated in NPPES

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NPPES data as of · Source: CMS NPPES

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