DR. JOHN WILLIAM ANTONETZ (NPI# 1255422622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255422622 |
| Entity Type | Individual |
| Full Name | DR. JOHN WILLIAM ANTONETZ |
| Credential | DDS |
| Practice Address |
2200 Fort Roots Dr North Little Rock AR 72114-1709 |
| Mailing Address |
11127 Gila Valley Dr Little Rock AR 72212-3505 |
| Practice Telephone | 5012571000 |
| Mailing Telephone | 5012259437 |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223D0001X |
Dentist Specialization: Dental Public Health |
030938 | NY | Dental Providers |
| Street Address |
2200 FORT ROOTS DR |
| City | NORTH LITTLE ROCK |
| State | AR |
| Zip Code | 72114-1709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750388401 | Ivy V Mcgee | Family Medicine | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2005-07-07 |
| 1477161586 | Kaila Mitchell | Psychologist | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2020-07-15 |
| 1689200040 | Tonie Brenee' Williams | Social Worker | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2020-03-18 |
| 1447899646 | Eugenia Boozer | Clinical Neuropsychologist | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2020-01-06 |
| 1376181263 | Linda Shrader | Technician | 2200 Fort Roots Dr, North Little Rock, AR 72114 | 2019-12-11 |
| 1205470507 | Julie Renee Thyberg | Technician | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2019-10-30 |
| 1588215966 | Venius Vernester Russell | Technician | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2019-09-26 |
| 1538718119 | Mary Kathryn Martin | Technician | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2019-09-06 |
| 1689223596 | Meriline White | Technician | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2019-09-04 |
| 1124677943 | Felicia Clayton | Technician | 2200 Fort Roots Dr, North Little Rock, AR 72114 | 2019-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316432966 | Mid State Counseling and Recovery Service | Clinic/Center | 1920 Main St Ste 229, North Little Rock, AR 72114 | 2018-06-26 |
| 1053826842 | Kelli Lauron Johnson | Nurse Practitioner | 2800 North Willow Street, North Little Rock, AR 72114 | 2017-12-03 |
| 1689117756 | State of Arkansas | Skilled Nursing Facility | 2401 John Ashley Drive, Building #100, North Little Rock, AR 72114 | 2016-11-22 |
| 1366787459 | J Andrew Mccullough | Counselor | 628 W Broadway St Ste 300, North Little Rock, AR 72114 | 2012-11-30 |
| 1598071490 | Roger Elliott Hicks IIi | Counselor | 2200 Fort Roots Dr # 3d, North Little Rock, AR 72114 | 2010-08-30 |
| 1740594456 | Tuyet Thi Van | Dentist | 520 W. Pershing Blvd., North Little Rock, AR 72114 | 2010-08-05 |
| 1467764183 | Jennifer Leigh Nash | Behavioral Analyst | 628 W Broadway St Ste 100, North Little Rock, AR 72114 | 2010-07-10 |
| 1336398544 | Tina A Davie | Registered Nurse | 2200 Foot Roots Drive, Little Rock, AR 72114 | 2008-09-11 |
| 1316125313 | Centers for Youth & Families | Community/Behavioral Health | 200 W. 20th, North Little Rock, AR 72114 | 2008-02-01 |
| 1881878064 | Marie A Graham | Nurse Practitioner | 636 West Broadway St, No Little Rock, AR 72114 | 2007-12-24 |
| Find all providers in zip 72114 | ||||
| Taxonomy Code | 1223D0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Dental Public Health |
| The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467875161 | Nancy E. Malcolm Ltd | Dentist | 910 Enterprise Dr, Jonesboro, AR 72401-9239 | 2014-01-31 |
| 1982883039 | Kevin S. Pierce, D.d.s. P.a. | Dentist | 1724 Executive Sq, Jonesboro, AR 72401-6092 | 2007-10-25 |
| 1124151345 | Andrea M. Smith | Dentist | 1400 Dale Bumpers Dr, Forrest City, AR 72335-2695 | 2007-03-14 |
| 1902989460 | Samuel Todd Swann | Dentist | 15 Wilson Farm Rd, Greenbrier, AR 72058-0248 | 2006-10-20 |
| 1275622755 | Mark E. Pickett | Dentist | 135 Cash Rd Nw, Camden, AR 71701-3833 | 2006-10-12 |
| 1588778641 | Mark A, Davis | Dentist | 15775 Highway 16 E, Shirley, AR 72153-8930 | 2006-08-18 |
| 1801317375 | Nick Grote Family Dental Pa | Dentist | 611 Jefferson St, Van Buren, AR 72956-5159 | 2017-07-05 |
| City | NORTH LITTLE ROCK |
| Zip Code | 72114 |
Please comment or provide details below to improve the information on DR. JOHN WILLIAM ANTONETZ.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.