Active NPI
Edward A Vela, DDS
- Dentist
- Ratcliff, AR
National Provider Identifier
1699707661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3550
- Practice address
- 9755 W State Hwy 22
Ratcliff, AR 72951 - Phone
- (479) 635-5300
- Fax
- (479) 635-4700
- NPI assigned
- Jul 7, 2006
- Last updated
- Jul 24, 2007
- Sex
- Male
- 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 | 3550 | AR | Primary |
Addresses
Primary practice location
9755 W State Hwy 22
Ratcliff, AR 72951
Mailing address
9755 W State Hwy 22
PO Box 130
Ratcliff, AR 72951
Phone (479) 635-5300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151204000932 | AR | Order and Referring Only - Oral Surgery | 1254631773 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185235200000",
"number": "1699707661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9755 W STATE HWY 22",
"address_2": "PO BOX 130",
"city": "RATCLIFF",
"state": "AR",
"postal_code": "72951",
"telephone_number": "479-635-5300",
"fax_number": "479-635-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9755 W STATE HWY 22",
"city": "RATCLIFF",
"state": "AR",
"postal_code": "72951",
"telephone_number": "479-635-5300",
"fax_number": "479-635-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELA",
"first_name": "EDWARD",
"middle_name": "A",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "3550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ratcliff, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.