John C. Udouj, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2744 Issued in AR

Practice address

2600 Market Trce
Suite B
Fort Smith, AR 72908-8681

Phone

(479) 648-9988

Fax

(479) 648-9996

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144329871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 MARKET TRCE",
            "address_2": "SUITE B",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729088681",
            "telephone_number": "479-648-9988",
            "fax_number": "479-648-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MARKET TRCE",
            "address_2": "SUITE B",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729088681",
            "telephone_number": "479-648-9988",
            "fax_number": "479-648-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDOUJ",
        "first_name": "JOHN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Kristen Tyson
• Stephanie N Tyson, RN
• Uams
• Uams Family Medical Center Facility
• Henry Joseph Udouj III, D.D.S.
• Stan M Udouj, D.M.D.
• Judith Nneka Ugwu Erugo, MD
• Ndidibuike N Ukwe, MD
• Nuttha Ungnapatanin, M.D.
• Union Medical Supply,LLC

• General Practice Dentistry in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.