Active NPI
Jessica L Teale, DDS
- Dentist
- Malvern, AR
National Provider Identifier
1568876530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3988
- Practice address
- 937 S Main St
Malvern, AR 72104-5220 - Phone
- (501) 337-9559
- NPI assigned
- Jun 17, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3988 | AR | Primary |
Addresses
Primary practice location
937 S Main St
Malvern, AR 72104-5220
Mailing address
937 S Main St
Malvern, AR 72104-5220
Phone (501) 337-9559
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 |
|---|---|---|---|
| 3988 | AR | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576540800000",
"number": "1568876530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "937 S MAIN ST",
"city": "MALVERN",
"state": "AR",
"postal_code": "721045220",
"telephone_number": "501-337-9559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "937 S MAIN ST",
"city": "MALVERN",
"state": "AR",
"postal_code": "721045220",
"telephone_number": "501-337-9559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEALE",
"first_name": "JESSICA",
"middle_name": "L",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-17",
"last_updated": "2019-12-17",
"certification_date": "2019-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "3988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malvern, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.