McQueen Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

4178 Issued in AR

Legal business name

MCQUEEN DENTAL PLLC

Practice address

640 N Garland Ave
Fayetteville, AR 72701-3116

Phone

(479) 521-2653

NPI assigned

May 10, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Van Michael McQueen, DDS

Title

Owner

Phone

(870) 926-0471

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bold Dental Doing business as

Locations

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525910400000",
    "number": "1497245997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3321 INDIAN SPRINGS AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727628852",
            "telephone_number": "870-926-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 N GARLAND AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727013116",
            "telephone_number": "479-521-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCQUEEN DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-10",
        "last_updated": "2018-05-10",
        "status": "A",
        "authorized_official_last_name": "MCQUEEN",
        "authorized_official_first_name": "VAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-926-0471",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AR",
            "license": "4178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1518496215",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bold Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William McNair, MD
• Colin Ryan McNay
• Richard Dean McNeel, D.D.S.
• Maria Camille McNeill, OTA
• Ariel Marie McPherson, MMT
• Van Michael McQueen Jr., DDS
• Matthew McShane, D.D.S.
• Stacey Lynn McSpadden, COTA
• Richard D McWhorter, MD
• Davin Means

• Dental Clinic/Center in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Dental Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.