Terry L. Fiddler, D.D.S., P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2115 Issued in AR

Legal business name

TERRY L. FIDDLER, D.D.S., P.A.

Practice address

562 Locust Street
Conway, AR 72034

Phone

(501) 327-7778

NPI assigned

Oct 4, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sissy Moore

Title

Office Manager

Phone

(501) 327-7778

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Terry Lee Fiddler, D.D.S.

  • General Practice Dentistry
  • Conway, AR
  • NPI 1871717728
  NPD (past)
• James Matthew Fulmer, D.D.S.

  • General Practice Dentistry
  • Conway, AR
  • NPI 1710100995
  NPD (past)
• Marley Rose Jones, DDS

  • General Practice Dentistry
  • Conway, AR
  • NPI 1225962681
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881789865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 LOCUST STREET",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "72034",
            "telephone_number": "501-327-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 LOCUST STREET",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "72034",
            "telephone_number": "501-327-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRY L. FIDDLER, D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "SISSY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "501-327-7778"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "858661",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "58493",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hailey Ashlyn Tedder, RBT
• Traci Temples
• Michalli Kathleen Tencleve, OT
• Ralph Tennessee
• Gerson Airel Teran, M.D.
• Sunjung Kim Thao
• The Golden Touch LLC
• The Pain Medicine Consultants Group
• Therapy Assessment Center LLC
• Therapy Assessment Center LLC

• General Practice Dentistry in Conway, AR
• Providers in Conway, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.