G FRIEND DDS MS & M WILSON DDS MS PA (NPI# 1619960440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619960440 |
| Entity Type | Organization |
| Organization Name | G FRIEND DDS MS & M WILSON DDS MS PA |
| Other Organization Name | CONWAY PEDIATRIC DENTAL GROUP |
| Practice Address |
2700 Allyson Lane Conway AR 72034 |
| Mailing Address |
Po Box 11020 Conway AR 72034-0018 |
| Practice Telephone | 5017300375 |
| Practice Fax Number | 5017300335 |
| Mailing Telephone | 5017300375 |
| Mailing Fax Number | 5017300335 |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. GERALD W FRIEND (OWNER) |
| Authorized Official Telephone | 5017300375 |
| 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 |
2793 | AR | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2817 | AR | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
3475 | AR | Dental Providers |
| Other Name | Type Code |
|---|---|
| Conway Pediatric Dental Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508889478 | G Friend Dds Ms & M Wilson Dds Ms Pa | Dentist | 4605 Fairway Ave, North Little Rock, AR 72116 | 2006-07-25 |
| Street Address |
2700 ALLYSON LANE |
| City | CONWAY |
| State | AR |
| Zip Code | 72034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811913999 | Gerald William Friend | Dentist | 2700 Allyson Lane, Conway, AR 72034 | 2006-07-14 |
| 1508882465 | Jason Scott Havard | Dentist | 2700 Allyson Lane, Conway, AR 72034 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013563758 | Shelby M Perez | Case Manager/Care Coordinator | 3240 Stermer Rd, Conway, AR 72034 | 2019-08-16 |
| 1467932772 | Faith J Parfait | Licensed Practical Nurse | 1352 Watkins St, Conway, AR 72034 | 2018-08-16 |
| 1043790611 | David Adam Steinfeld | Nurse Practitioner | 855 S German Ln Ste 1, Conway, AR 72034 | 2018-08-14 |
| 1245728484 | Conway Behavioral Health, LLC | Psychiatry & Neurology | 2255 Sturgis Rd, Conway, AR 72034 | 2018-04-24 |
| 1972007292 | Eldercare of Arkansas IIi, Inc. | Assisted Living Facility | 1306 S. Donaghey, Conway, AR 72034 | 2018-03-21 |
| 1528561404 | Kouhei Kobayashi | Specialist/Technologist | 2201 Moix Blvd., Apt. 908, Conway, AR 72034 | 2018-03-16 |
| 1780191015 | Sydnie Thessing | Nurse Practitioner | 605 Dave Ward Drive #105, Conway, AR 72034 | 2018-01-09 |
| 1508371865 | Ebony Latreace Charleston | Case Manager/Care Coordinator | 3240 Stermer Road, Conway, AR 72034 | 2017-12-08 |
| 1689190647 | Denise Annette Aikman | Dentist | 1210 Hogan Lane, Suite 200, Conway, AR 72034 | 2017-08-21 |
| 1134669138 | Hortons Orthotic Lab, Inc. | Prosthetic/Orthotic Supplier | 635 Dave Ward, Suite 103, Conway, AR 72034 | 2017-02-24 |
| Find all providers in zip 72034 | ||||
| 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 |
|---|---|---|---|---|
| 1225194558 | Waccamaw Pediatric Dental Care, LLC | Dentist | 158 Waccamaw Medical Park Ct, Conway, SC 29526-8965 | 2006-12-29 |
| 1669890349 | Aaron K. Forrester Dds, Pllc | Dentist | 2425 Dave Ward Dr Ste 502, Conway, AR 72034-8686 | 2014-03-31 |
| 1811913999 | Gerald William Friend | Dentist | 2700 Allyson Lane, Conway, AR 72034 | 2006-07-14 |
| 1508882465 | Jason Scott Havard | Dentist | 2700 Allyson Lane, Conway, AR 72034 | 2006-07-14 |
| 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 | ||||
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.