Custom Dental of Edmond, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5978 Issued in OK

Legal business name

CUSTOM DENTAL OF EDMOND, PLLC

Practice address

17840 N. Penn
Oklahoma City, OK 73012

Phone

(405) 282-6440

Fax

(405) 282-6785

NPI assigned

Jan 10, 2011

Last updated

Sep 15, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Grant Pitt, DDS

Title

Dentist

Phone

(405) 282-6440

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1013211846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17840 N PENNSYLVANIA AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730129097",
            "telephone_number": "405-282-6440",
            "fax_number": "405-282-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17840 N. PENN",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73012",
            "telephone_number": "405-282-6440",
            "fax_number": "405-282-6785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM DENTAL OF EDMOND, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "PITT",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "405-282-6440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryder Mansel Curtis
• Scott Arthur Curtis
• Shana Curtis, RBT
• Veronica V Curtis I, NURSE PRACTITIONER
• Cheryl Custer, M.ED.,CCC,SLP
• Custom Dental South Oklahoma City
• Custom Pharmacy Innovations Inc
• McKenzie Nichole Cutter
• Courtney Cuzalina, APRN, CNP
• Cvi Oklahoma, P.C

• 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 Sep 15, 2011; 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.