Individual provider Active NPI

Ralph A Teed, D.D.S.,P.A

  • General Practice Dentistry
  • Newport, AR
National Provider Identifier
1902830722
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2453 Issued in AR
Practice address
1200 McLain St Ste 8
Suite 8
Newport, AR 72112-3534
Phone
(870) 523-6555
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2453 AR Primary

Addresses

Primary practice location

1200 McLain St Ste 8
Suite 8
Newport, AR 72112-3534

Mailing address

5405 Cord Rd
Newark, AR 72562-9489
Phone (870) 523-6555

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160122000625 AR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1658674890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2453ARMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ralph a Teed DDS,PA Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902830722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 CORD RD",
            "city": "NEWARK",
            "state": "AR",
            "postal_code": "725629489",
            "telephone_number": "870-523-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MCLAIN ST STE 8",
            "address_2": "SUITE 8",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "721123534",
            "telephone_number": "870-523-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEED",
        "first_name": "RALPH",
        "middle_name": "A",
        "credential": "D.D.S.,P.A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, AR

Sources for this page

Verify at the official NPI Registry.