PDG Dental Group PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PDG DENTAL GROUP PLLC

Practice address

4605 Fairway Ave
North Little Rock, AR 72116

Phone

(501) 771-2990

Fax

(501) 753-0408

NPI assigned

Sep 14, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie G Meek, DDS

Title

Owner

Phone

(501) 771-2990

Specialties & licenses 1

Addresses

Other names 1

• North Little Rock Pediatric Dental Group Doing business as

Tax ID family

Conway Pediatric Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• PDG Dental Group PLLC

  • Pediatric Dentistry
  • Conway, AR
  • NPI 1245952472
  NPD tax ID

Practitioners 1

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

• Mark Edward Wilson, DDS MS

  • Pediatric Dentistry
  • North Little Rock, AR
  • NPI 1912924424
  NPD (past)

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1346962586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 FAIRWAY AVE",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "72116",
            "telephone_number": "501-771-2990",
            "fax_number": "501-753-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 FAIRWAY AVE",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "72116",
            "telephone_number": "501-771-2990",
            "fax_number": "501-753-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PDG DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "MEEK",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-771-2990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Little Rock Pediatric Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Poorvi Chetan Patel
• Tirth Mukeshbhai Patel, MD
• Kelsy Jane Patterson, A.T.C., L.A.T.
• Joredia Patton
• Jennifer Ann Paulson, PH.D.
• Carla Jobeth Peace, PA-C
• Parker Drake Pearson, DMD
• Peder Jensen, DMD, PA
• Jody Peebles, M.D.
• Rebecca M Pence

• Pediatric Dentistry in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Pediatric Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.