Southern Smiles Dental PC

Primary specialty

DentistTaxonomy code 122300000X

License

6412 Issued in OK

Legal business name

SOUTHERN SMILES DENTAL PC

Practice address

8816 S Pennsylvania Ave
Suite 300
Oklahoma City, OK 73159-5232

Phone

(405) 682-4665

Fax

(405) 682-0667

NPI assigned

Jan 9, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jaycee Starr Van Horn, 6412NPI 1962764365

Title

Owner/Dentist

Phone

(580) 284-8142

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Jaycee Starr Van Horn, D.D.S.

  • General Practice Dentistry
  • Oklahoma City, OK
  • NPI 1962764365
  NPD (past) Authorized official
• H Dyke Moffatt, D.D.S.

  • Dentist
  • Oklahoma City, OK
  • NPI 1770593402
  NPD (past)

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1033508312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8816 S PENNSYLVANIA AVE",
            "address_2": "SUITE 300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731595232",
            "telephone_number": "405-682-4665",
            "fax_number": "405-682-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8816 S PENNSYLVANIA AVE",
            "address_2": "SUITE 300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731595232",
            "telephone_number": "405-682-4665",
            "fax_number": "405-682-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SMILES DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "VAN HORN",
        "authorized_official_first_name": "JAYCEE",
        "authorized_official_middle_name": "STARR",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "580-284-8142",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "6412"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "6412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy E Southerland, LMFT
• Megan Southerland
• Southern Oklahoma Treatment Services, Inc
• Southern Oklahoma Treatment Services, Inc.
• Southern Plains Medical Center Inc
• Southerncare, Inc
• Leroy Southmayd III, M.D.
• Southpointe Dental PLLC
• Southpointe Family Dentistry PLLC Dba Westmoore Family Dentistry
• Southridge Dental Arts PLLC

• Dentist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.