DR. KELLY-GWYNNE MASON FERGUS DDS, MDS
NPI 1093979254
Dentist - Orthodontics and Dentofacial Orthopedics in Jonesboro, AR

Active since July 16, 2008
2812 HARRISBURG RD, JONESBORO, AR 72401(870) 336-3366(870) 336-3360 Get Directions Write a Review

NPPES record last updated: June 2, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Kelly-gwynne Mason Fergus Dds, Mds NPPES

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

DR. KELLY-GWYNNE MASON FERGUS DDS, MDS (NPI 1093979254) is an individual orthodontics and dentofacial orthopedics provider in Jonesboro, Arkansas, licensed in Arkansas (3659) and active in the NPI registry since July 2008.

NPPES Registry Identity

NPI1093979254
Entity TypeIndividualFemale
Primary Taxonomy1223X0400X
Provider Legal NameDR. KELLY-GWYNNE MASON FERGUSCredential: DDS, MDS
Location Address2812 HARRISBURG RDJonesboro, AR 72401-6081
Mailing Address2812 Harrisburg RdJonesboro, AR 72401-6081 · (870) 336-3366 · Fax (870) 336-3360
Fax(870) 336-3360
Sole ProprietorYes
Enumeration DateJuly 16, 2008
Last NPPES UpdateJune 2, 2015
NPI 1093979254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Orthodontics and Dentofacial OrthopedicsDental Providers
Taxonomy Code1223X0400X
License Licensed in AR · 3659
Definition

That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.

2812 HARRISBURG RD, Jonesboro, AR 72401

Accepted Insurance

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1093979254, enumerated as an "individual" on July 16, 2008.

The provider is located at 2812 HARRISBURG RD JONESBORO, AR 72401 and the phone number is (870) 336-3366.

Dentist with taxonomy code 1223X0400X and a focus in Orthodontics and Dentofacial Orthopedics.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Arkansas Blue. Please consult your insurance carrier or call the provider to verify.