Axpm Jonesboro Pedo, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

AXPM JONESBORO PEDO, PLLC

Doing business as

Leap Kids Dental- Jonesboro

Practice address

1150 E Matthews Ave
Ste 102
Jonesboro, AR 72401-4346

Phone

(870) 931-5437

NPI assigned

Jan 4, 2017

Last updated

Jan 4, 2017By 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

Mark Dake

Title

Owner

Phone

(501) 781-2777

Specialties & licenses 1

Addresses

Other names 1

• Leap Kids Dental- Jonesboro Doing business as

Locations

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483488000000",
    "number": "1861937518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3450",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722033450",
            "telephone_number": "501-781-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 E MATTHEWS AVE",
            "address_2": "STE 102",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014346",
            "telephone_number": "870-931-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXPM JONESBORO PEDO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-04",
        "last_updated": "2017-01-04",
        "status": "A",
        "authorized_official_last_name": "DAKE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-781-2777"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leap Kids Dental- Jonesboro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Visa Lahang Avance, OTA
• Raegan Avrit, OTD
• Awanna LLC (Awanna Smith)
• Lena Z Awar, MD
• Ziad Awar, M.D.,
• Axpm Jonesboro, PLLC
• Nathaniel Ayers
• Trichina Ayers, MHPP
• Back in Action of Jonesboro, Inc.
• Dominique Leigh Bacot

• Pediatric Dentistry in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Pediatric Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.