CREIGHTON DESHAWN POWELL (NPI# 1689103038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689103038 |
| Entity Type | Individual |
| Full Name | CREIGHTON DESHAWN POWELL |
| Practice Address |
1699 Stadium Blvd Suite I Jonesboro AR 72401 |
| Mailing Address |
1699 Red Wolf Blvd Ste I Jonesboro AR 72401-5453 |
| Practice Telephone | (870) 336-0543 |
| Practice Fax Number | 8703360061 |
| Mailing Telephone | 8703360543 |
| Mailing Fax Number | 8703360061 |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2017-06-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
4169 | AR | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 168292631 | 05 |
| Street Address |
1699 STADIUM BLVD SUITE I |
| 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 | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063023554 | Christopher Marshall | Dentist | 1804 Old Greensboro Rd Bldg B, Jonesboro, AR 72405-0003 | 2020-08-10 |
| 1255859831 | Southern Dental of Hilltop Pllc | Dentist | 2000 Fielder Drive, Jonesboro, AR 72401 | 2017-09-05 |
| 1972039220 | Steven Andrew Robinson | Dentist | 2007 E Nettleton Ave Ste C, Jonesboro, AR 72401 | 2017-05-05 |
| 1376904953 | Southern Dental of Jonesboro, Pllc | Dentist | 2500 Browns Ln Ste A, Jonesboro, AR 72401-6107 | 2016-03-10 |
| 1205211976 | Higginbotham Dental Group, Pllc | Dentist | 1804 Old Greensboro Rd Ste D, Jonesboro, AR 72405-2076 | 2015-07-23 |
| 1306275474 | A.y. Dental Health, Inc | Dentist | 772 North Ave, Jonesboro, GA 30236-2226 | 2013-11-08 |
| 1053637637 | Gairhan Dental Care, Pllc | Dentist | 460 Southwest Dr Ste B, Jonesboro, AR 72401-5855 | 2010-04-08 |
| 1538494240 | Candace R Thomas | Dentist | 236 Stockbridge Rd Ste A, Jonesboro, GA 30236-3629 | 2009-10-14 |
| 1841428117 | Emily Gairhan | Dentist | 3113 Annadale Cv., Jonesboro, AR 72404-9515 | 2009-06-25 |
| 1144461773 | Tyrer Dentistry, Pa | Dentist | 2603 Brown's Lane, Jonesboro, AR 72401 | 2009-03-11 |
| 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.