Kidz Choice West Memphis PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

KIDZ CHOICE WEST MEMPHIS PLLC

Practice address

316 W Tyler Ave
West Memphis, AR 72301-4225

Phone

(870) 400-8127

NPI assigned

Aug 26, 2015

Organization subpart

Yes

Parent organization

STEWART DENTAL SERVICES, INC.As reported in NPPES

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

Authorized official

Name

Todd Stewart, DDS

Title

Owner

Phone

(501) 225-1577

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451260800000",
    "number": "1487021465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12018 CHENAL PKWY",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112759",
            "telephone_number": "501-225-1577",
            "fax_number": "501-219-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 W TYLER AVE",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014225",
            "telephone_number": "870-400-8127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDZ CHOICE WEST MEMPHIS PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STEWART DENTAL SERVICES, INC.",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-12-28",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-225-1577",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487021465",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.