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NORTHWEST ARKANSAS PEDIATRIC DENTAL CENTER NPI 1033155411


NPI Information

NPI: 1033155411
Provider Name: NORTHWEST ARKANSAS PEDIATRIC DENTAL CENTER

Doing Business As: SMILE SHOPPE PEDIATRIC DENTISTRY

Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
5518 WALSH LN
ROGERS, AR
ZIP 72758
Phone: (479) 631-6377
Get Directions

NORTHWEST ARKANSAS PEDIATRIC DENTAL CENTER is a pediatric dentistry dentist in Rogers, AR. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. NORTHWEST ARKANSAS PEDIATRIC DENTAL CENTER NPI is 1033155411. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Smile Shoppe Pediatric Dentistry.

The provider's business location address is:

5518 WALSH LN
ROGERS, AR
ZIP 72758-947
Phone: (479) 631-6377
Fax: (479) 273-5967

The provider's authorized official is Jeffrey D Rhodes .
The authorized official title is President and has the following contact phone number (479) 631-6377.

The enumeration date for this NPI number is 6/22/2006 and was last updated on 1/19/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223P0221XDentistPediatric Dentistry2924ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1159561631MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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