Individual provider Active NPI

Tina Joy Morehart, DDS

  • Dentist
  • Oklahoma City, OK
National Provider Identifier
1063561819
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5821 Issued in OK
Practice address
500 N Walker Ave Ste E500
Oklahoma City, OK 73102
Phone
(405) 208-8844
Fax
(405) 208-8844
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5821 OK Primary
General Practice Dentistry 1223G0001X 5821 OK

Addresses

Primary practice location

500 N Walker Ave Ste E500
Oklahoma City, OK 73102

Mailing address

500 N Walker Ave Ste E500
Oklahoma City, OK 73102
Phone (405) 208-8844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160405002138 OK Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4183922271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5821OKMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1063561819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N WALKER AVE STE E500",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73102",
            "telephone_number": "405-208-8844",
            "fax_number": "405-208-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N WALKER AVE STE E500",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73102",
            "telephone_number": "405-208-8844",
            "fax_number": "405-208-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREHART",
        "first_name": "TINA",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "5821",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5821",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.