Mco Peds PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6362 Issued in OK

Legal business name

MCO PEDS PLLC

Practice address

404 S Elm St Ste D
Jenks, OK 74037-3766

Phone

(918) 998-0998

Fax

(918) 998-0998

NPI assigned

Jul 5, 2017

Last updated

Nov 8, 2023By 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

Creed Cardon

Title

Owner

Phone

(918) 998-0996

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1053832675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERWALK TER STE 250",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375619",
            "telephone_number": "918-998-0996",
            "fax_number": "918-235-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 S ELM ST STE D",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740373766",
            "telephone_number": "918-998-0998",
            "fax_number": "918-998-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCO PEDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-05",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "CARDON",
        "authorized_official_first_name": "CREED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-998-0996"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "6362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teressa J McHenry, MD
• William Graham McIntyre, DPT
• Taja McKesson
• Natalie Lyn McLain, CCC-SLP
• Abby Rae McNeely, OTR/L
• Gretchen Abigail Pearl McPherson
• Taylor Christine Medina, FNP-C, FNP-BC
• Kylie Brynne Meerholz, M.S, CCC-SLP
• Melinda Dandridge DO PLLC
• Alexandra Metcalf

• General Practice Dentistry in Jenks, OK
• Providers in Jenks, 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 Nov 8, 2023; 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.