Individual provider Active NPI

Elvys Ferrufino-Mejia, DDS

  • General Practice Dentistry
  • Conway, AR
National Provider Identifier
1477237998
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4828 Issued in AR
Practice address
635 Dave Ward Dr
Conway, AR 72034-7083
Phone
(501) 449-2906
NPI assigned
Jun 14, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4388-23 MS
General Practice Dentistry 1223G0001X 4828 AR Primary

Addresses

Primary practice location

635 Dave Ward Dr
Conway, AR 72034-7083

Mailing address

406 Cedar Chase Dr
West Memphis, AR 72301-2978
Phone (479) 622-3119

Other practice location 1

2372 Springhill Rd
Bryant, AR 72019-7572
Phone (501) 449-0789

Other practice location 2

940 Church Rd W
Southaven, MS 38671-9611
Phone (662) 253-8027

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

LicenseStateTypeSpecialty
4388-23MSMDDentist
4828ARMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1477237998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 CEDAR CHASE DR",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723012978",
            "telephone_number": "479-622-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 DAVE WARD DR",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347083",
            "telephone_number": "501-449-2906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2372 Springhill Rd",
            "address_purpose": "LOCATION",
            "city": "Bryant",
            "state": "AR",
            "postal_code": "720197572",
            "country_code": "US",
            "telephone_number": "501-449-0789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "940 Church Rd W",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386719611",
            "country_code": "US",
            "telephone_number": "662-253-8027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERRUFINO-MEJIA",
        "first_name": "ELVYS",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-14",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "4388-23",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "4828",
            "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 Aug 11, 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.

Verify at the official NPI Registry.