Active NPI
Ted W Jolley, DDS
- Dentist
- Little Rock, AR
National Provider Identifier
1306152434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3389
- Practice address
- 10319 W Markham St Ste 100
Little Rock, AR 72205-4555 - Phone
- (501) 227-5567
- Fax
- (501) 227-5268
- NPI assigned
- Aug 26, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3389 | AR | Primary |
Addresses
Primary practice location
10319 W Markham St Ste 100
Little Rock, AR 72205-4555
Mailing address
10319 W Markham St Ste 100
Little Rock, AR 72205-4555
Phone (501) 227-5567
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3389 | AR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fallon Davis, D.D.S. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Little Rock, AR
- NPI 1346441102
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674000000000",
"number": "1306152434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10319 W MARKHAM ST STE 100",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722054555",
"telephone_number": "501-227-5567",
"fax_number": "501-227-5268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10319 W MARKHAM ST STE 100",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722054555",
"telephone_number": "501-227-5567",
"fax_number": "501-227-5268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLLEY",
"first_name": "TED",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-26",
"last_updated": "2023-01-18",
"certification_date": "2023-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "3389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.