Provider Demographics
NPI:1154401057
Name:SANDERS, TOMPKINS, SCHIRO, LANDERS AND SANDERS PLLC
Entity type:Organization
Organization Name:SANDERS, TOMPKINS, SCHIRO, LANDERS AND SANDERS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROCIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-582-0600
Mailing Address - Street 1:1607 E RAINFOREST DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5385
Mailing Address - Country:US
Mailing Address - Phone:479-582-0600
Mailing Address - Fax:479-443-4630
Practice Address - Street 1:1607 E RAINFOREST DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5385
Practice Address - Country:US
Practice Address - Phone:479-582-0600
Practice Address - Fax:479-443-4630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR157248631Medicaid
AR5C635OtherBCBS,HEALTH ADVANTAGE
KS414939OtherBCBS OF KS
AR1400699OtherUCCI/US ABLE PROVIDER