Fergus Orthodontics PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

115 Issued in AR

Legal business name

FERGUS ORTHODONTICS PLLC

Practice address

801 Osler Drive
Suite D
Jonesboro, AR 72401

Phone

(870) 336-3366

Fax

(870) 336-3366

NPI assigned

Aug 3, 2011

Organization subpart

No

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

Authorized official

Name

Kelly Gwynne Mason Fergus, DDS,MS

Title

Sole MBR

Phone

(870) 336-3366

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1003194317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 OSLER DRIVE",
            "address_2": "SUITE D",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401",
            "telephone_number": "870-336-3366",
            "fax_number": "870-336-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 OSLER DRIVE",
            "address_2": "SUITE D",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "72401",
            "telephone_number": "870-336-3366",
            "fax_number": "870-336-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERGUS ORTHODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-03",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "FERGUS",
        "authorized_official_first_name": "KELLY GWYNNE",
        "authorized_official_middle_name": "MASON",
        "authorized_official_title_or_position": "SOLE  MBR",
        "authorized_official_telephone_number": "870-336-3366",
        "authorized_official_credential": "DDS,MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AR",
            "license": "115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Felder
• Corey Christopher Felts, DPT
• Jakob Felts
• Madison Felts, PT, DPT
• Travis Fender
• Kelly-Gwynne Mason Fergus, DDS, MDS
• Justin L Ferguson, MHPP
• Shawna R Ferguson, APRN
• Deborah Lynn Fernon, LCSW
• Sabaina Feroz, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; 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.