Ted W Jolley DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3389 Issued in AR

Legal business name

TED W JOLLEY DDS PLLC

Practice address

22450 I 30
Bryant, AR 72022

Phone

(501) 847-1889

Fax

(501) 847-4105

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ted Wilson Jolley, DDS

Title

Dentist

Phone

(501) 847-1889

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982767547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22450 I 30",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "72022",
            "telephone_number": "501-847-1889",
            "fax_number": "501-847-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22450 I 30",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "72022",
            "telephone_number": "501-847-1889",
            "fax_number": "501-847-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TED W JOLLEY DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOLLEY",
        "authorized_official_first_name": "TED",
        "authorized_official_middle_name": "WILSON",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "501-847-1889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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.