NPIMap

Organization Active NPI

Congo Dental, PLLC

  • Clinic/Center
  • Benton, AR
National Provider Identifier
1295423192
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CONGO DENTAL, PLLC
Practice address
2101 Congo Rd Ste C
Benton, AR 72015-2703
Phone
(501) 778-1400
Fax
(501) 778-6194
NPI assigned
Apr 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Authorized official

Name
Dr. Tracy Marie Schroepfer, DMDNPI 1154973303
Title
Dentist
Phone
(501) 778-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2101 Congo Rd Ste C
Benton, AR 72015-2703

Mailing address

2101 Congo Rd Ste C
Benton, AR 72015-2703
Phone (501) 778-1400

Other names 1

  • Congo Dental Studio Doing business as

National Provider Directory

National Provider Directory

Locations

2101 Congo Rd
Ste C
Benton, AR 72015
Phone (501) 778-1400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1295423192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 CONGO RD STE C",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152703",
            "telephone_number": "501-778-1400",
            "fax_number": "501-778-6194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 CONGO RD STE C",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152703",
            "telephone_number": "501-778-1400",
            "fax_number": "501-778-6194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONGO DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "SCHROEPFER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "501-778-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Congo Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benton, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; 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.