AXPM SW LITTLE ROCK PEDO, PLLC (NPI# 1881053361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881053361 |
| Entity Type | Organization |
| Organization Name | AXPM SW LITTLE ROCK PEDO, PLLC |
| Practice Address |
9100 Geyer Springs Rd Little Rock AR 72209-6425 |
| Mailing Address |
Po Box 24470 Little Rock AR 72221-4470 |
| Practice Telephone | 5015650444 |
| Mailing Telephone | 5017812777 |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2016-02-12 |
| Authorized Official Name | BRYAN HILLER (OWNER) |
| Authorized Official Telephone | 5017812777 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
3763 | AR | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
3321 | AR | Dental Providers |
| Street Address |
9100 GEYER SPRINGS RD |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72209-6425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386280527 | Tiffany Williams | Counselor | 9914 I-30 Frontage, Little Rock, AR 72209 | 2019-11-22 |
| 1659913861 | Jerry Dean Swiney | Technician | 8401 Community Road, Little Rock, AR 72209 | 2019-10-09 |
| 1720501307 | A2z Therapy of Little Rock | Clinic/Center | 10702 Warren Dr, Little Rock, AR 72209 | 2017-07-25 |
| 1235582560 | Elite Medical Care, LLC | Respiratory Therapist, Registered | 11701 Interstate 30 Ste 100, Little Rock, AR 72209 | 2016-07-21 |
| 1154772127 | Aminah Henderson | Case Manager/Care Coordinator | 9914 I-30 Frontage Rd., Little Rock, AR 72209 | 2016-06-30 |
| 1295151504 | Properly Aligned LLC | Chiropractor | 7117 Geyer Springs, Little Rock, AR 72209 | 2014-03-11 |
| 1396178471 | Renal Treatment Centers - Southeast Lp | Clinic/Center | 6115 Baseline Rd, Ste 100, Little Rock, AR 72209 | 2013-08-13 |
| 1124378039 | Samuel Edward Adkins | Counselor | 9914 I-30 Frontage Road, Little Rock, AR 72209 | 2012-09-18 |
| 1073806790 | Gabrielle Stewart | Counselor | 9914 I-30 Frontage Rd, Little Rock, AR 72209 | 2011-05-27 |
| 1285951079 | Charles Jenson | Psychiatry & Neurology | 11321 Interstate 30 Ste 304, Little Rock, AR 72209 | 2010-05-03 |
| Find all providers in zip 72209 | ||||
| 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 |
|---|---|---|---|---|
| 1669098208 | Dr. Joseph M. Mazurek, Inc | Dentist | 6500 Baseline Rd, Little Rock, AR 72209-4732 | 2020-06-19 |
| 1386849362 | Cara Janique Jones | Dentist | 5905 W 12th St, Little Rock, AR 72204-1608 | 2007-06-19 |
| 1013127505 | Bryan Keith Angel | Dentist | 300 S Rodney Parham Rd Ste 3, Little Rock, AR 72205-4774 | 2007-05-23 |
| 1992854558 | Michael Anthony Kitchens | Dentist | 14114 Taylor Loop Rd, Little Rock, AR 72223 | 2007-01-10 |
| 1730283334 | Joseph M Mazurek | Dentist | 6500 Baseline Road, Little Rock, AR 72209 | 2006-09-12 |
| 1336620020 | Small Bites | Dentist | 1001 S Bowman Rd Ste 1, Little Rock, AR 72211-3710 | 2018-08-22 |
| 1437601788 | Apex Dental Partners Pllc | Dentist | 1701 Centerview Dr, Suite 114, Little Rock, AR 72211-4308 | 2016-11-02 |
| 1174949622 | Arkansas Pediatric Dentistry | Dentist | 5905 W 12th St, Little Rock, AR 72204-1608 | 2014-03-07 |
| 1003258245 | Arkansas Pediatric Dentistry | Dentist | 5905 W 12th St, Little Rock, AR 72204-1608 | 2013-07-29 |
| 1649591256 | Brandon Jeffrey Kitchens | Dentist | 14114 Taylor Loop Rd, Little Rock, AR 72223-4308 | 2010-06-17 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72209 |
Please comment or provide details below to improve the information on AXPM SW LITTLE ROCK PEDO, PLLC.
| 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.