TACY MARIE SUNDELL (NPI# 1689687584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689687584 |
| Entity Type | Individual |
| Full Name | TACY MARIE SUNDELL |
| Credential | DDS |
| Practice Address |
11300 Cantrell Rd Ste 303 Little Rock AR 72212-1844 |
| Practice Telephone | 5012285700 |
| Mailing Telephone | 5012285700 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
3352 | AR | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BLUE CROSS PROVIDER NUMBE | 5X406 | 01 |
| AR | UNITED CONCORDIA | 1493112 | 01 |
| Street Address |
11300 CANTRELL RD STE 303 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72212-1844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407869399 | Ernest Stanley Woodard | Dentist | 11300 Cantrell Rd Ste 303, Little Rock, AR 72212-1844 | 2006-08-14 |
| 1821001637 | Drs. Woodard & Sundell, Dds, Pa | Dentist | 11300 Cantrell Rd Ste 303, Little Rock, AR 72212-1844 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475805 | Arkansas Health Group | Dietitian, Registered | 10915 Rodney Parham Road, Suite G, Little Rock, AR 72212 | 2020-10-20 |
| 1043788045 | Arkansas Wellness Associates LLC | Internal Medicine | 10700 N Rodney Parham Road, Suite C11, Little Rock, AR 72212 | 2018-11-07 |
| 1538663729 | Premier Gastroenterology Associates Pllc | Internal Medicine | 10915 N. Rodney Parham, Suite B, Little Rock, AR 72212 | 2018-03-21 |
| 1942749148 | Reece Lewis Crow | General Practice | 34 Windsor Road, Little Rock, AR 72212 | 2017-02-21 |
| 1174910210 | Jourdan Quinn | Nurse Practitioner | 11300 Cantrell Rd Ste 204, Little Rock, AR 72212 | 2015-04-15 |
| 1174942528 | Jacey Tanner Guthrie | Dermatology | 4200 N Rodney Parham Rd Ste 202, Little Rock, AR 72212 | 2014-04-14 |
| 1366867525 | Rustee Danielle Pruitt | Counselor | 1719 Merrill Drive, Little Rock, AR 72212 | 2014-02-25 |
| 1932520558 | Diana Johnson Pearson | Speech-Language Pathologist | 3920 Woodland Heights Rd., Little Rock, AR 72212 | 2013-12-27 |
| 1275968786 | Bill F Hefley Sr. | Allergy & Immunology | 361 Valley Club Circle, Little Rock, AR 72212 | 2013-09-04 |
| 1376987693 | Robert Carlton Power | Internal Medicine | 8 Bella View Drive, Little Rock, AR 72212 | 2013-04-18 |
| Find all providers in zip 72212 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295862357 | Jerry E. Bradley | Dentist | 1225 Breckenridge Drive, Suite 110, Little Rock, AR 72205 | 2007-02-27 |
| 1336163542 | Donald Paul Callan | Dentist | 10319 W. Markham St., Suite 300, Little Rock, AR 72205-4556 | 2006-07-27 |
| 1568442788 | John Edward Svendsen | Dentist | 16101 Lagrande Dr, Suite 101, Little Rock, AR 72223-9140 | 2006-01-23 |
| 1396189270 | Pinnacle Periodontics | Dentist | 1225 Breckenridge Dr, #110, Little Rock, AR 72205-1558 | 2013-04-23 |
| 1821001637 | Drs. Woodard & Sundell, Dds, Pa | Dentist | 11300 Cantrell Rd Ste 303, Little Rock, AR 72212-1844 | 2006-08-14 |
| 1306853775 | John Robert Spray | Dentist | 4815 W Markham St, Slot 33, Little Rock, AR 72205-3866 | 2006-08-01 |
| 1134134703 | Marny L Lemons-prince | Dentist | 1225 Breckenridge Dr, Suite 210, Little Rock, AR 72205-1558 | 2006-07-30 |
| 1265446165 | Arkansas Periodontal Associates | Dentist | 10319 W. Markham St., Suite 300, Little Rock, AR 72205-4556 | 2006-07-28 |
| 1548202856 | Lloyd F. Church Jr. | Dentist | 10310 W Markham St, Suite 301, Little Rock, AR 72205-2175 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154793982 | White & Blansett Periodontics & Dental Implants | Dentist | 201 N 34th St, Rogers, AR 72756-0352 | 2015-10-20 |
| 1790819233 | Ronald Howell Follis | Dentist | 800 W B St, Russellville, AR 72801-3610 | 2007-03-15 |
| 1407907165 | Peder J Jensen | Dentist | 2501 Crestwood Rd Ste 102, North Little Rock, AR 72116-7615 | 2007-01-16 |
| 1154496297 | Charles Adrian White | Dentist | 201 N 34th, Rogers, AR 72756 | 2006-11-22 |
| 1780772962 | Michael L. Thompson | Dentist | 2737 Paula Dr, Jonesboro, AR 72404-8017 | 2006-10-11 |
| 1497852495 | Michael Curry | Dentist | 1831 N Green Acres Rd, Fayetteville, AR 72703-2615 | 2006-09-20 |
| 1225134828 | Charles J. Antonini, Dds, Ms | Dentist | 200 Mcauley Ct, Hot Springs, AR 71913-6312 | 2006-09-15 |
| 1497762090 | Harry Hoffman Morgan | Dentist | 3800 Rogers Ave Ste 3, Fort Smith, AR 72903-3074 | 2006-08-03 |
| 1689626269 | Stephen A Rappeport | Dentist | 304 N Greenwood Ave, Fort Smith, AR 72901-3454 | 2006-05-16 |
| 1295730562 | D. Ross Atkinson | Dentist | 2633 Malvern Ave, Hot Springs, AR 71901-8176 | 2005-06-14 |
| Find all providers with the same taxonomy | ||||
| City | LITTLE ROCK |
| Zip Code | 72212 |
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| 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.