Provider Demographics
NPI:1730389602
Name:MEHAFFEY, EMILY BISHOP (DMD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:BISHOP
Last Name:MEHAFFEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:LONOKE
Mailing Address - State:AR
Mailing Address - Zip Code:72086-2805
Mailing Address - Country:US
Mailing Address - Phone:501-676-6770
Mailing Address - Fax:
Practice Address - Street 1:5111 JFK BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-6722
Practice Address - Country:US
Practice Address - Phone:501-753-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR36291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice