G FRIEND DDS MS & M WILSON DDS MS PA (NPI# 1508889478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508889478 |
| Entity Type | Organization |
| Organization Name | G FRIEND DDS MS & M WILSON DDS MS PA |
| Other Organization Name | NORTH LITTLE ROCK PEDIATRIC DENTAL GROUP |
| Practice Address |
4605 Fairway Ave North Little Rock AR 72116 |
| Practice Telephone | 5017712990 |
| Practice Fax Number | 5017580408 |
| Mailing Telephone | 5017712990 |
| Mailing Fax Number | 5017530408 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MARK E WILSON (CO OWNER) |
| Authorized Official Telephone | 5017712990 |
| Authorized Official Credential | DDS MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2817 | AR | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2700 | AR | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2793 | AR | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BCBS | 5B771 | 01 |
| Other Name | Type Code |
|---|---|
| North Little Rock Pediatric Dental Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619960440 | G Friend Dds Ms & M Wilson Dds Ms Pa | Dentist | 2700 Allyson Lane, Conway, AR 72034 | 2005-08-26 |
| Street Address |
4605 FAIRWAY AVE |
| City | NORTH LITTLE ROCK |
| State | AR |
| Zip Code | 72116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912924424 | Mark Edward Wilson | Dentist | 4605 Fairway Ave, North Little Rock, AR 72116 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710509997 | Dickerson Family Resource Center, LLC | Counselor | 5401 John F. Kennedy Blvd, Suite I Rm 1, North Little Rock, AR 72116 | 2020-05-11 |
| 1831609262 | Bill J Carpenter Sr. | Counselor | 4700 W Commercial Dr Ste B3, North Little Rock, AR 72116 | 2017-10-12 |
| 1992257646 | Meagan Booe | Behavioral Analyst | 3812 Lakewood Valley Drive, North Little Rock, AR 72116 | 2016-10-28 |
| 1295154300 | Min-ji Lee | Family Medicine | 2504 Mccain Blvd Ste 118, North Little Rock, AR 72116 | 2014-04-16 |
| 1255603486 | Crystal N Lackey | Physical Therapist | 3801 Jfk Blvd Ste C, North Little Rock, AR 72116 | 2012-02-03 |
| 1003055724 | North Little Rock, Pllc | Chiropractor | 4614 Jfk Blvd, North Little Rock, AR 72116 | 2009-02-19 |
| 1891933826 | Jennifer Ann Freilino | Counselor | 3805 Mccain Park Dr Ste 112, North Little Rock, AR 72116 | 2009-01-29 |
| 1679729669 | Amy Marie Jones | Speech-Language Pathologist | 5901 John F Kennedy Blvd Apt 5127, North Little Rock, AR 72116 | 2008-08-11 |
| 1992970917 | Ronald F Boyles Od Pa | Eyewear Supplier (Equipment, not the service) | 2520 Crestwood Road, North Little Rock, AR 72116 | 2008-04-30 |
| 1992976377 | Kencur Inc Statco Hearing Labs | Hearing Instrument Specialist | 4000 Mccain Blvd, Suite D, North Little Rock, AR 72116 | 2008-03-13 |
| Find all providers in zip 72116 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912924424 | Mark Edward Wilson | Dentist | 4605 Fairway Ave, North Little Rock, AR 72116 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669098208 | Dr. Joseph M. Mazurek, Inc | Dentist | 6500 Baseline Rd, Little Rock, AR 72209-4732 | 2020-06-19 |
| 1508334400 | Smile Shoppe Fayetteville Jeffrey D. Rhodes Dds Ms Pllc | Dentist | 3484 W Wedington Dr, Fayetteville, AR 72704-5730 | 2018-11-08 |
| 1609234269 | Bethel Burris Oliver | Dentist | 2713 W Kings Highway, Paragould, AR 72450 | 2016-02-10 |
| 1114339926 | Amanda Hankins | Dentist | 5518 W Walsh Ln, Rogers, AR 72758-8947 | 2014-05-28 |
| 1881018786 | My Village Smiles, Pllc | Dentist | 1104 Poplar Pl, Rogers, AR 72756-4249 | 2014-02-12 |
| 1689974362 | Karen Anne Green | Dentist | 1607 E Rainforest Rd, Fayetteville, AR 72703 | 2010-10-27 |
| 1740508217 | Sarah Norris Farmer | Dentist | 3310 Hwy 5 N, Bryant, AR 72019-9031 | 2010-05-09 |
| 1760648174 | James L Bevans Pediatric Dentistry Pa | Dentist | 7409 Alcoa Road, Suite 5, Bryant, AR 72022 | 2008-08-05 |
| 1720242167 | Summer Barker Tyson | Dentist | 620 Southwest Dr, Jonesboro, AR 72401-5859 | 2008-07-15 |
| 1225211196 | John Michael Burrows | Dentist | 303 Bancario, Ste 11-12, Marion, AR 72364-2825 | 2007-12-13 |
| Find all providers with the same taxonomy | ||||
| City | NORTH LITTLE ROCK |
| Zip Code | 72116 |
Please comment or provide details below to improve the information on G FRIEND DDS MS & M WILSON DDS MS PA.
| 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.