KLW DENTISTRY (NPI# 1689053597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689053597 |
| Entity Type | Organization |
| Organization Name | KLW DENTISTRY |
| Other Organization Name | TAYLOR WAGNER FAMILY DENTISTRY |
| Practice Address |
2000 Fielders Rd Jonesboro AR 72401-1937 |
| Practice Telephone | 8709726985 |
| Practice Fax Number | 8709725536 |
| Mailing Telephone | 8709726985 |
| Mailing Fax Number | 8709725536 |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |
| Authorized Official Name | DR. KATY WAGNER (OWNER) |
| Authorized Official Telephone | 8709726985 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Taylor Wagner Family Dentistry | Doing Business As Name - Organization |
| Street Address |
2000 FIELDERS RD |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401-1937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184700494 | Kathryn Lee Massey Wagner | Dentist | 2000 Fielders Rd, Jonesboro, AR 72401-1937 | 2006-10-29 |
| 1497019673 | Taylor Wagner Family Dentistry | Dentist | 2000 Fielders Rd, Jonesboro, AR 72401-1937 | 2012-07-02 |
| 1154684165 | Garrett Harley Webb | Dentist | 2000 Fielders Rd, Jonesboro, AR 72401-1937 | 2012-06-25 |
| 1275785693 | Bruce W. Taylor, D.d.s. | Dentist | 2000 Fielders Rd, Jonesboro, AR 72401-1937 | 2008-10-16 |
| 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 | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336680552 | Mujtaba Alamiri | Dentist | 3206 Elmhurst Dr, Jonesboro, AR 72404-9616 | 2017-03-20 |
| 1558712166 | Corey Haughey | Dentist | 1804 Old Greensboro Rd, Jonesboro, AR 72401-1896 | 2016-06-24 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1922476571 | Tmj and Facial Pain Center,llc | Dentist | 2600 Browns Lane, Ste B, Jonesboro, AR 72404 | 2015-09-11 |
| 1265828156 | Hd Dental, Pa Dba Smile Dental | Dentist | 6009 Highway 1 South, Jonesboro, AR 72404 | 2015-04-08 |
| 1578966974 | Aspen Dental | Dentist | 2203 Stadium Blvd, Jonesboro, AR 72401 | 2014-09-30 |
| 1780012203 | Texas Dental Implant Center | Dentist | 1237 County Road 197, Jonesboro, TX 76538-1207 | 2013-10-18 |
| 1588003362 | William Reynolds Little | Dentist | 3637 E. Johnson Ave., Suite B, Jonesboro, AR 72401 | 2013-06-14 |
| 1871841817 | Ashland Doomes | Dentist | 301 N Main St Jonesboro, Jonesboro, GA 30236 | 2012-08-23 |
| 1164643011 | Jeremy Lynn Adams | Dentist | 911 Osler Dr Ste D, Jonesboro, AR 72401-4320 | 2007-05-01 |
| Find all providers in JONESBORO | ||||
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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.