Summit Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3717 Issued in AR

Legal business name

SUMMIT DENTAL CARE

Practice address

3860 Highway 412 E Ste F
Siloam Springs, AR 72761-8499

Phone

(479) 524-9379

Fax

(479) 524-0976

NPI assigned

Aug 5, 2013

Organization subpart

No

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

Authorized official

Name

Peter Neilson Jeppsen, DDS

Title

Owner

Phone

(479) 524-9379

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375660800000",
    "number": "1194157818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 HIGHWAY 412 E STE F",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727618499",
            "telephone_number": "479-524-9379",
            "fax_number": "479-524-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 HIGHWAY 412 E STE F",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727618499",
            "telephone_number": "479-524-9379",
            "fax_number": "479-524-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-05",
        "last_updated": "2013-08-05",
        "status": "A",
        "authorized_official_last_name": "JEPPSEN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "NEILSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-524-9379",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180792608",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200268160A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven M Stinnett, PT
• Vance Stock, M.D.
• Brandon Ray Stroope, D.M.D.
• Angela K Stuart, LPC
• Vicroria Lynn Sullivan, LPC
• Supportive Care of Arkansas LLC
• Supportive Psych Care of Arkansas PA
• Sweet P Speech LLC
• Ronald George Syler, DDS
• Corine Elyse Taylor, MS

• General Practice Dentistry in Siloam Springs, AR
• Providers in Siloam Springs, 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 Aug 5, 2013; 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.