Active NPI
Andrew Plichta
- Dentist
- Conway, AR
National Provider Identifier
1417797176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4841
- Practice address
- 1125 S Amity Rd
Conway, AR 72032-8090 - Phone
- (501) 764-4465
- NPI assigned
- May 30, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30.027573 | OH | |
| Dentist | 122300000X | 4841 | AR | Primary |
Addresses
Primary practice location
1125 S Amity Rd
Conway, AR 72032-8090
Mailing address
6775 Crown Dr
Brownsburg, IN 46112-9100
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 |
|---|---|---|---|
| 4841 | AR | MD | Dentist |
| 30.027573 | OH | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TD Dental LLC | 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.
-
- Public Health Dentistry
- Akron, OH
- NPI 1932964400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753401600000",
"number": "1417797176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6775 CROWN DR",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "461129100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 S AMITY RD",
"city": "CONWAY",
"state": "AR",
"postal_code": "720328090",
"telephone_number": "501-764-4465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLICHTA",
"first_name": "ANDREW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-30",
"last_updated": "2025-07-25",
"certification_date": "2025-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "30.027573",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "4841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.