MCQUEEN DENTAL PLLC (NPI# 1497245997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497245997 |
| Entity Type | Organization |
| Organization Name | MCQUEEN DENTAL PLLC |
| Other Organization Name | BOLD DENTAL |
| Practice Address |
640 N Garland Ave Fayetteville AR 72701-3116 |
| Mailing Address |
3321 Indian Springs Ave Springdale AR 72762-8852 |
| Practice Telephone | 4795212653 |
| Mailing Telephone | 8709260471 |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2018-05-10 |
| Authorized Official Name | DR. VAN MICHAEL MCQUEEN (OWNER) |
| Authorized Official Telephone | 8709260471 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
4178 | AR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | INDIVIDUAL NPI | 1518496215 | 01 |
| Other Name | Type Code |
|---|---|
| Bold Dental | Doing Business As Name - Organization |
| Street Address |
640 N GARLAND AVE |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72701-3116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144348582 | Taruna Sharma Bolding | Dentist | 640 N Garland Ave, Suite 104, Fayetteville, AR 72701-3116 | 2007-03-26 |
| 1508296005 | Andrew C Johnson | Dentist | 640 N Garland Ave, Suite 104, Fayetteville, AR 72701-3116 | 2013-11-19 |
| 1619311198 | Bold Dental Partners Pllc | Dentist | 640 N Garland Ave, Suite 104, Fayetteville, AR 72701 | 2013-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588213417 | Biggers Counseling, LLC | Social Worker | 349 S Hill Ave, Fayetteville, AR 72701 | 2019-09-04 |
| 1235603200 | Arkansas Holistic Health Care Chiropractic | Chiropractor | 2618 Mlk Jr Blvd, Fayetteville, AR 72701 | 2019-01-14 |
| 1225520828 | Jacoby Markie Clemons | Specialist/Technologist | 1201 West Leroy Pond Dr, Fayetteville, AR 72701 | 2018-05-31 |
| 1952892390 | Ambur Dryer | Specialist/Technologist | 994 W Mlk Jr. Blvd., Fayetteville, AR 72701 | 2018-05-22 |
| 1851814230 | Blakely Low | Psychologist | 1229 Meadow Street Suite #221, Jones Family Center for Student-athlete Success, Fayetteville, AR 72701 | 2017-07-18 |
| 1518496215 | Van Michael Mcqueen Jr. | Dentist | 640 N Garland Ave # 104, Fayetteville, AR 72701 | 2017-06-06 |
| 1407204217 | Kenna Megan Hodeaux | Specialist/Technologist | 1201 Leroy Pond Drive, Sports Medicine Department, Fayetteville, AR 72701 | 2016-06-02 |
| 1740634435 | Crystal Susan Rofkahr | Psychologist | 26 E Meadow St Ste 3, Fayetteville, AR 72701 | 2016-04-19 |
| 1942663521 | Satoshi IIda | Specialist/Technologist | 1010 S Dunn Ave., Apt 205a, Fayetteville, AR 72701 | 2016-04-01 |
| 1992163901 | Dr Don M Chaney Dds Pa | Dentist | 1826 N. Crossover Road, Suite 2, Fayetteville, AR 72701 | 2016-02-04 |
| Find all providers in zip 72701 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437615408 | Dr Cameron and Associates Iv | Clinic/Center | 2301 Robeson St Ste 302, Fayetteville, NC 28305-5641 | 2019-02-14 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1306329867 | James E Rice, Dds Pa | Clinic/Center | 3622 Morganton Rd, Fayetteville, NC 28303-4967 | 2018-09-11 |
| 1346744232 | Wedington Dental, Pllc | Clinic/Center | 3500 Black Forest Drvie, Ste 1, Fayetteville, AR 72704 | 2018-03-23 |
| 1639568777 | Hollis L Jones Dds, Pllc | Clinic/Center | 1782 Metromedical Dr, Fayetteville, NC 28304-3861 | 2015-01-13 |
| 1366856262 | Dr Cameron and Associates IIi, Pllc | Clinic/Center | 300 Glensford Drive, Fayetteville, NC 28314 | 2014-06-18 |
| 1053618801 | B.g.harrison D.d.s. and Associates, P.a. | Clinic/Center | 1408 Skibo Rd., Fayetteville, NC 28303 | 2011-02-14 |
| 1104155506 | Patrice A. Barber, Dds & Associates, Pa | Clinic/Center | 5428 Yadkin Rd, Fayetteville, NC 28303-3199 | 2009-12-14 |
| 1508471046 | Fayetteville Smiles Dentistry | Clinic/Center | 6962 Highbridge Rd, Fayetteville, NY 13066-9705 | 2020-09-11 |
| 1295373322 | Sequoyah Dental, Pllc | Clinic/Center | 2827 E Millennium Pl Ste 3, Fayetteville, AR 72703-6528 | 2019-12-19 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72701 |
Please comment or provide details below to improve the information on MCQUEEN DENTAL PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.