NPIMap

Organization Active NPI

Dental Professionals of Ok, PC

  • General Practice Dentistry
  • Edmond, OK
National Provider Identifier
1013311265
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF OK, PC
Practice address
3152 S Broadway
Edmond, OK 73013-4056
Phone
(405) 696-4168
NPI assigned
Oct 17, 2014
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF OK, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Authorized official

Name
Jennifer Hoelscher
Title
Insurance/Credentialing
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3152 S Broadway
Edmond, OK 73013-4056

Mailing address

3152 S Broadway
Edmond, OK 73013-4056
Phone (405) 696-4168

Other names 1

  • Cross Timbers Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Health Associates of Texas PC10 organizations share this tax ID, including this one
Part of
Dental Health Associates of Texas PC

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3152 S Broadway
Edmond, OK 73013
Phone (405) 696-4168

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1013311265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3152 S BROADWAY",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730134056",
            "telephone_number": "405-696-4168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3152 S BROADWAY",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730134056",
            "telephone_number": "405-696-4168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF OK, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF OK, PC",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "HOELSCHER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "INSURANCE/CREDENTIALING",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cross Timbers Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.