Luke Wayne Adlong, DDS
Individual provider Active NPI Dentist · Conway, AR
NPI 1922458090 · NPPES record last updated May 31, 2018
Key facts
- NPI
- 1922458090
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 4101 (AR)
- Practice address
- 2755 Prince St
Conway, AR 72034-3635 - Phone
- (501) 329-7474
- NPI assigned
- Jun 20, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4101 | AR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakefront Dental PLLC | Past | Accepting new patients | |
| Luke Adlong DDS PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4101 | AR | Yes |
Addresses
Primary practice location
2755 Prince St
Conway, AR 72034-3635
Mailing address
95 Beaverfork Rd
Conway, AR 72032-9517
Phone (501) 327-6529
Other practice location 1
95 Beaverfork Rd
Conway, AR 72032-9517
Phone (501) 327-6529
Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.