STEPHEN ALLEN MODELEVSKY (NPI# 1477647089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477647089 |
| Entity Type | Individual |
| Full Name | STEPHEN ALLEN MODELEVSKY |
| Credential | DDS |
| Practice Address |
906 Osler Drive Jonesboro AR 72401 |
| Mailing Address |
Po Box 1920 Jonesboro AR 72403 |
| Practice Telephone | 8709728570 |
| Practice Fax Number | 8709725451 |
| Mailing Telephone | 8709728570 |
| Mailing Fax Number | 8709725451 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
2302 | AR | Dental Providers |
| Street Address |
906 OSLER DRIVE |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 1223P0106X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Pathology |
| The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588176630 | Integrative Dental Specialists Pllc | Dentist | 3333 S Pinnacle Hills Pkwy Ste 140, Rogers, AR 72758-8953 | 2017-10-30 |
| 1356668826 | Kay Amin Cashman Dds Pllc | Dentist | 390 E Longview St, Fayetteville, AR 72703-4618 | 2010-04-23 |
| 1780690065 | Bob E. Anderson | Dentist | 1 Saint Vincent Cir, #240, Little Rock, AR 72205-5405 | 2006-07-31 |
| 1164491155 | Kay Amin Cashman | Dentist | 390 E Longview St, Fayetteville, AR 72703-4618 | 2006-03-14 |
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| 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.