Healthcare Provider Details

I. General information

NPI: 1013854082
Provider Name (Legal Business Name): ELIZABETH KLONARIS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 S ROCKWOOD DR STE A
CABOT AR
72023-2885
US

IV. Provider business mailing address

122 WINDHAM LOOP
STATEN ISLAND NY
10314-5914
US

V. Phone/Fax

Practice location:
  • Phone: 501-628-9501
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4919
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: