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General NPI Number Information
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NPI Number | 1477237998
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Entity Type | Individual
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Provider Name | ELVYS FERRUFINO-MEJIA DDS
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Gender | Male
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Dates
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Enumeration Date | 06/14/2023
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 635 DAVE WARD DR
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City | CONWAY
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State | AR
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Zip | 72034-7083
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Country | US
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Telephone | 501-449-2906
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Fax |
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Provider Business Mailing Address
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Address Line | 406 CEDAR CHASE DR
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-2978
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Country | US
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Telephone | 479-622-3119
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4388-23
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4828
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License Number State | AR
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