Dental Depot 62ND & South Western PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL DEPOT 62ND & SOUTH WESTERN PLLC

Practice address

6217 S Western Ave
Oklahoma City, OK 73139-1605

Phone

(405) 606-7123

Fax

(405) 606-7130

NPI assigned

Aug 19, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Glenn Allen Ashmore, DDSNPI 1750379921

Title

President

Phone

(405) 949-0123

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Glenn A Ashmore, DDS

  • General Practice Dentistry
  • Oklahoma City, OK
  • NPI 1750379921
  NPD (past) Authorized official
• Jake Ryan Higginson, D.M.D

  • Dentist
  • Oklahoma City, OK
  • NPI 1255773339
  NPD (past)
• Curtis Lowell Tsai, DDS

  • General Practice Dentistry
  • Huntington Beach, CA
  • NPI 1588140461
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624579200000",
    "number": "1003196239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 NW 30TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731127404",
            "telephone_number": "405-606-7123",
            "fax_number": "405-606-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6217 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731391605",
            "telephone_number": "405-606-7123",
            "fax_number": "405-606-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL DEPOT 62ND & SOUTH WESTERN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A",
        "authorized_official_last_name": "ASHMORE",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-949-0123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Evangeline Dennison, LD
• Jennifer Lee Denny, OTRL
• Je'Ana Denson
• Lataurus Denson
• Dental Boutique PLLC
• Dental Depot Hefner Station
• Dental Depot of 10004 South Memorial Drive PLLC
• Dental Depot of 145TH & N. Penn
• Dental Depot of 164TH & Portland PLLC
• Dental Depot of 63Rd & NW Expressway, PLLC

• General Practice Dentistry in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.