Kidz Choice Dental PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

2841 Issued in AR

Legal business name

KIDZ CHOICE DENTAL PA

Practice address

2415 Prince St Ste 105
Conway, AR 72034-3746

Phone

(501) 327-2030

Fax

(501) 327-0242

NPI assigned

Apr 20, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Edwin Kyle Dalton, DDS

Title

President

Phone

(501) 327-2030

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334880000000",
    "number": "1003173634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 PRINCE ST STE 105",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343746",
            "telephone_number": "501-327-2030",
            "fax_number": "501-327-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 PRINCE ST STE 105",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343746",
            "telephone_number": "501-327-2030",
            "fax_number": "501-327-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZ CHOICE DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-20",
        "last_updated": "2012-04-20",
        "status": "A",
        "authorized_official_last_name": "DALTON",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-327-2030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AR",
            "license": "2841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kid Success, Inc.
• Amanda Jean Kidd
• Ellie Nicole Kidd, OT
• Kids ABA Services
• Kidz Choice Conway LLC
• Chris J Killingsworth, M.D.
• Anita Marie Killins, DPT
• Yong Jun Kim, ATC, LAT
• Sherry Kimbrell
• Theodore Kindle, CMP

• Dental Clinic/Center in Conway, AR
• Providers in Conway, AR by specialty
• Dental Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.