1. Home
  2. Directory
  3. Arkansas
  4. Conway
  5. Dentist
  6. NPI Profile

CONWAY REGIONAL INTERFAITH DENTAL CLINIC
NPI 1043864093
Dentist - General Practice in Conway, AR

Active since July 29, 2019CLIA 04D0466269 · Accreditation
830 N CREEK DR, CONWAY, AR 72032(501) 932-0559(501) 205-1983 Get Directions Write a Review

NPPES record last updated: November 9, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 9, 2023, Jan 16, 2023, Dec 14, 2022 and 2 more (5 updates tracked since 2019).

About Conway Regional Interfaith Dental Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONWAY REGIONAL INTERFAITH DENTAL CLINIC (NPI 1043864093) is a healthcare organization registered as a general practice in Conway, Arkansas and active in the NPI registry since July 2019. The organization holds an CLIA Accreditation certificate valid through November 30, 2027 and lists William Pack, Cfo, as its authorized official.

NPPES Registry Identity

NPI1043864093
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameCONWAY REGIONAL MEDICAL CENTER, INC
Location Address830 N CREEK DRConway, AR 72032-4711
Mailing AddressPo Box 9662Conway, AR 72033-9662 · (501) 852-1363
Phone(501) 932-0559
Fax(501) 205-1983
Organization SubpartNo
Authorized OfficialWilliam PackCfo · (501) 450-2112
Enumeration DateJuly 29, 2019
Last NPPES UpdateNovember 9, 20235 updates tracked since enumeration
NPPES CertifiedNovember 9, 2023
✔ NPI 1043864093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
830 N CREEK DR, Conway, AR 72032
Open in Google Maps ↗

Other Names 1

Doing Business AsConway Regional Interfaith Dental Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 04D0466269

Conway Regional Medical Center · Conway, AR
Active · expires Nov 30, 2027
CLIA Number04D0466269
Laboratory TypeHospital
Certificate Effective DateDecember 1, 2025
Certificate Expiration DateNovember 30, 2027
Laboratory DirectorDr. David N. Pope
Laboratory Phone(501) 513-5752
Laboratory LocationConway Regional Medical Center2302 College Avenue, Conway, AR 72032
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES ALFRED SUMMITT DDS
Dentist (General Practice)
830 N CREEK DR
CONWAY, AR 72032
Faulkner County (501) 932-0559
CATHOLIC HEALTH INITIATIVES -ST. VINCENT INTERFAITH CLINIC, INC
Dentist (General Practice)
830 N CREEK DR
CONWAY, AR 72032
Faulkner County (501) 932-0559

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Conway Regional Medical Center, Inc's NPI number?

The NPI number for Conway Regional Medical Center, Inc is 1043864093. It was assigned to this organization in the NPPES registry on July 29, 2019. The provider is doing business as Conway Regional Interfaith Dental Clinic.

Where is Conway Regional Medical Center, Inc located?

Conway Regional Medical Center, Inc is located at 830 N Creek Dr, Conway, AR 72032. The listed phone number is (501) 932-0559.

What is Conway Regional Medical Center, Inc's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Does Conway Regional Medical Center, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 04D0466269) is associated with this NPI, valid through November 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Conway Regional Medical Center, Inc was last updated on November 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.