MRS. TABITHA A WALLACE (NPI# 1629348198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629348198 |
| Entity Type | Individual |
| Full Name | MRS. TABITHA A WALLACE |
| Credential | RDH |
| Practice Address |
12921 Cantrell Road Suite 101 Little Rock AR 72223-1798 |
| Practice Telephone | 5016643279 |
| Practice Fax Number | 5016645392 |
| Mailing Telephone | 5016643279 |
| Mailing Fax Number | 5016645392 |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2011-12-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 2217 | AR | Dental Providers |
| Street Address |
12921 CANTRELL ROAD SUITE 101 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72223-1798 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952477457 | Annette Knight | Dental Assistant | 12921 Cantrell Road, Suite 101, Little Rock, AR 72223 | 2006-11-27 |
| 1740344944 | Donald Arthur Deems IIi | Dentist | 12921 Cantrell Road, Suite 101, Little Rock, AR 72223-1701 | 2006-12-21 |
| 1508932005 | Carol Ann Pierce | Dental Hygienist | 12921 Cantrell Road, Suite 101, Little Rock, AR 72223 | 2006-11-27 |
| 1578639167 | Donald A Deems IIi Dds Pa | Dentist | 12921 Cantrell Road, Suite 101, Little Rock, AR 72223-1701 | 2006-11-27 |
| 1316013824 | Cynthia Renee Myhand | Dental Assistant | 12921 Cantrell Road, Suite 101, Little Rock, AR 72223 | 2006-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102242 | Tyler Edward Hicks | Chiropractor | 14300 West Cantrell Rd Suite 10, Little Rock, AR 72223 | 2019-03-08 |
| 1396268090 | Dawn Bridges | Day Training/Habilitation Specialist | 3920 Woodland Heights Road, Little Rock, AR 72223 | 2017-07-25 |
| 1235666983 | Grant Dennis | Chiropractor | 8201 Ranch Blvd., Suite B5, Little Rock, AR 72223 | 2017-05-12 |
| 1730581588 | Axpm-wlr, LLC | Dentist | 16003 Chanel Parkway, Little Rock, AR 72223 | 2014-09-24 |
| 1730421454 | Artineli Foot Care Solutions Pllc | Clinic/Center | 801 Technology Drive, Suite D, Little Rock, AR 72223 | 2013-03-20 |
| 1669758801 | William Patton Phillips | Obstetrics & Gynecology | 19 Bishop Place, Little Rock, AR 72223 | 2011-11-02 |
| 1003112160 | All Children's Therapy, Inc | Speech-Language Pathologist | 12410 Cantrell Rd., Suite 200, Little Rock, AR 72223 | 2011-02-07 |
| 1558697227 | Malcbndr581, LLC | Skilled Nursing Facility | 6411 Valley Ranch Dr, Little Rock, AR 72223 | 2009-10-30 |
| 1356578298 | Miranda White | Social Worker | 10 Pennsylvania Ct, Little Rock, AR 72223 | 2009-06-18 |
| 1457596959 | Leslie Ann Parks | General Practice | 14524 Cantrell Rd Suite 160, Little Rock, AR 72223 | 2008-12-11 |
| Find all providers in zip 72223 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689912644 | Kathryn Dowell | Dental Hygienist | 12921 Cantrell Rd Ste 101, Little Rock, AR 72223-1798 | 2013-01-27 |
| 1508932005 | Carol Ann Pierce | Dental Hygienist | 12921 Cantrell Road, Suite 101, Little Rock, AR 72223 | 2006-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760009682 | Suguey Martinez | Dental Hygienist | 104 W Locke Ave, De Queen, AR 71832-2380 | 2020-06-26 |
| 1447653431 | Stacey Fletcher | Dental Hygienist | 908 W Laura St, Rogers, AR 72758-6509 | 2014-10-03 |
| 1093941627 | Jane Miranda Miles | Dental Hygienist | 312 Short Street, Benton, AR 72015 | 2009-06-10 |
| 1265643720 | Carol R. Dennis | Dental Hygienist | 3518 Lacrosse, Bryant, AR 72022-9314 | 2007-05-25 |
| 1013928381 | Audra M Hamilton | Dental Hygienist | 623 N 9th Street, Augusta, AR 72006 | 2006-08-11 |
| 1891271847 | Cathy Dawson | Dental Hygienist | 135 Cash Rd Nw, Camden, AR 71701-3833 | 2018-07-12 |
| 1477039428 | Leah Pope | Dental Hygienist | 135 Cash Rd Nw, Camden, AR 71701-3833 | 2018-07-12 |
| 1033512678 | Robin Cristy Ruppert | Dental Hygienist | 2200 Fort Roots Dr, Bldg. 32- Room 109, North Little Rock, AR 72114-1709 | 2014-09-26 |
| 1891135083 | Terry L. Watson Dmd Pa | Dental Hygienist | 1171 Highway 62 412, Ash Flat, AR 72513-9612 | 2013-07-02 |
| 1972940914 | Kiala Jean Kirby | Dental Hygienist | 2606 Browns Ln, Jonesboro, AR 72401-7226 | 2013-05-31 |
| Find all providers with the same taxonomy | ||||
| City | LITTLE ROCK |
| Zip Code | 72223 |
Please comment or provide details below to improve the information on MRS. TABITHA A WALLACE.
| 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.