Provider Demographics
NPI:1134324296
Name:MURPHY, VENT STEPHEN (DDS, MS)
Entity Type:Individual
Prefix:
First Name:VENT
Middle Name:STEPHEN
Last Name:MURPHY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72901-4736
Mailing Address - Country:US
Mailing Address - Phone:479-785-5437
Mailing Address - Fax:479-785-5534
Practice Address - Street 1:603 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-4736
Practice Address - Country:US
Practice Address - Phone:479-785-5437
Practice Address - Fax:479-785-5534
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR28221223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
632700OtherCONCORDIA
58456OtherBCBS
58456OtherBCBS