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UT PEDIATRIC DENTISTRY
NPI 1407988116
Dentist - Pediatric Dentistry in West Memphis, AR

Active since March 09, 2007
200 W TYLER AVE, WEST MEMPHIS, AR 72301(870) 733-3854(870) 733-3851 Get Directions Write a Review

NPPES record last updated: March 19, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Ut Pediatric Dentistry NPPES

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

UT PEDIATRIC DENTISTRY (NPI 1407988116) is a healthcare organization registered as a pediatric dentistry in West Memphis, Arkansas and active in the NPI registry since March 2007. The organization lists Sanford Jay Fenton, Chair, as its authorized official.

NPPES Registry Identity

NPI1407988116
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameUT PEDIATRIC DENTISTRY
Location Address200 W TYLER AVEWest Memphis, AR 72301-4223
Mailing Address200 W Tyler AveWest Memphis, AR 72301-4223 · (870) 733-3854 · Fax (870) 733-3851
Phone(870) 733-3854
Fax(870) 733-3851
Organization SubpartNo
Authorized OfficialSanford Jay FentonChair · (870) 733-3854
Enumeration DateMarch 9, 2007
Last NPPES UpdateMarch 19, 2009
✔ NPI 1407988116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
200 W TYLER AVE, West Memphis, AR 72301
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Other Identifiers 3

Medicaid107199608AR
Medicaid150226608AR
Medicaid111494608AR

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

Other Providers at the Same Location NPPES 20

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

DR. SHAKEB HASHMI MD
Internal Medicine
200 W TYLER AVE, CRITTENDEN REGIONAL HOSPITAL
WEST MEMPHIS, AR 72301
Crittenden County (870) 735-1500
DR. ROLAND R BROWN MD
Family Medicine
200 W TYLER AVE
WEST MEMPHIS, AR 72301
Crittenden County (870) 735-1500
DR. KANAKA VASUDEVAN MD
Anesthesiology
200 W TYLER AVE
WEST MEMPHIS, AR 72301
Crittenden County (870) 735-1500
CRITTENDEN EMERGENCY GROUP LLC
Emergency Medicine
200 W TYLER AVE
WEST MEMPHIS, AR 72301
Crittenden County (870) 735-1500
DR. ROBERT T SHULL JR. MD
Family Medicine
200 W TYLER AVE
WEST MEMPHIS, AR 72301
Crittenden County (870) 735-1500
CRITTENDEN HOSPITAL ASSOCIATION
General Acute Care Hospital
200 W TYLER AVE
WEST MEMPHIS, AR 72301
Crittenden County (870) 735-1500
MS. KATHLEEN M MAPLES APN
Nurse Practitioner
200 W TYLER AVE
WEST MEMPHIS, AR 72301
Crittenden County (501) 658-2718
CRITTENDEN HOSPITAL ASSOCIATION
Home Health
200 W TYLER AVE
WEST MEMPHIS, AR 72301
Crittenden County (870) 732-7777

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 Ut Pediatric Dentistry's NPI number?

The NPI number for Ut Pediatric Dentistry is 1407988116. It was assigned to this organization in the NPPES registry on March 9, 2007.

Where is Ut Pediatric Dentistry located?

Ut Pediatric Dentistry is located at 200 W Tyler Ave, West Memphis, AR 72301. The listed phone number is (870) 733-3854.

What is Ut Pediatric Dentistry's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Ut Pediatric Dentistry was last updated on March 19, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.