S Todd Phelan, DDS, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3489 Issued in AR

Legal business name

S TODD PHELAN, DDS, PA

Practice address

2102 W Pleasant Grove Rd
Suite 1
Rogers, AR 72758

Phone

(479) 636-3400

Fax

(479) 636-3407

NPI assigned

Oct 9, 2007

Last updated

Dec 11, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Todd Phelan, DDS

Title

President

Phone

(479) 636-3400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen Todd Phelan, D.D.S.

  • General Practice Dentistry
  • Rogers, AR
  • NPI 1508924903
  NPD (past)

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228953600000",
    "number": "1508054214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 W PLEASANT GROVE RD",
            "address_2": "SUITE 1",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-636-3400",
            "fax_number": "479-636-3407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 W PLEASANT GROVE RD",
            "address_2": "SUITE 1",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-636-3400",
            "fax_number": "479-636-3407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S TODD PHELAN, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2008-12-11",
        "status": "A",
        "authorized_official_last_name": "PHELAN",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-636-3400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167741631",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanna Noel Russell
• Ryan D. Monson, P.a.
• Lizbeth A. Ryan, D.O.M.
• Stefanie Anne Ryan, APN
• S McKenna, LLC
• Luis L Saclolo, PT
• Safe Haven Counseling & Wellness LLC
• Saged Psychotherapy Inc.
• Amrit Kaur Saini, DDS
• Bayan Salameh

• General Practice Dentistry in Rogers, AR
• Providers in Rogers, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; 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.