My Village Smiles, PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

2401 Issued in AR

Legal business name

MY VILLAGE SMILES, PLLC

Practice address

1104 Poplar PL
Rogers, AR 72756-4249

Phone

(479) 621-9500

Fax

(479) 202-5361

NPI assigned

Feb 12, 2014

Last updated

Feb 12, 2014By 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

William T Mahon, D.D.S., M.S., M.S

Title

Owner

Phone

(479) 621-9500

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392163200000",
    "number": "1881018786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 POPLAR PL",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727564249",
            "telephone_number": "479-621-9500",
            "fax_number": "479-202-5361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 POPLAR PL",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727564249",
            "telephone_number": "479-621-9500",
            "fax_number": "479-202-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY VILLAGE SMILES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-12",
        "last_updated": "2014-02-12",
        "status": "A",
        "authorized_official_last_name": "MAHON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-621-9500",
        "authorized_official_credential": "D.D.S., M.S., M.S"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AR",
            "license": "2401",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AR",
            "license": "2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jim S Myers, O.D.
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• Orthodontics and Dentofacial Orthopedics Dentistry in Rogers, AR
• Providers in Rogers, AR by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2014; 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.