Active NPI
Andrew Audel Sandoval, DDS
- Dentist
- Jonesboro, AR
National Provider Identifier
1588158554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4447
- Practice address
- 2203 Red Wolf Blvd Ste a
Jonesboro, AR 72401-6327 - Phone
- (870) 277-2341
- NPI assigned
- Jun 21, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4447 | AR | Primary |
| Dentist | 122300000X | 2018017585 | MO | |
| Dentist | 122300000X | DN27846 | FL |
Addresses
Primary practice location
2203 Red Wolf Blvd Ste a
Jonesboro, AR 72401-6327
Mailing address
2203 Red Wolf Blvd Ste a
Jonesboro, AR 72401-6327
Phone (818) 808-8735
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 |
|---|---|---|---|
| DN27846 | FL | MD | Dentist |
| 2018017585 | MO | MD | Dentist |
| 4447 | AR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761264000000",
"number": "1588158554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2203 RED WOLF BLVD STE A",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724016327",
"telephone_number": "818-808-8735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2203 RED WOLF BLVD STE A",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724016327",
"telephone_number": "870-277-2341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "ANDREW",
"middle_name": "AUDEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-21",
"last_updated": "2025-10-24",
"certification_date": "2025-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "4447",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2018017585",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN27846",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.