Dustin Shaun Tedesco PLLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

25729 Issued in OK

Legal business name

DUSTIN SHAUN TEDESCO PLLC

Practice address

1553 N Porter Ave
Norman, OK 73071-6621

Phone

(405) 217-8500

Fax

(405) 217-8501

NPI assigned

May 5, 2014

Last updated

May 5, 2014By 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

Shaun Tedesco, MD

Title

Owner/Physician

Phone

(405) 936-0504

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dustin Shawn Tedesco, MD

  • Internal Medicine Physician
  • Norman, OK
  • NPI 1649476136
  NPD (past)

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1063822633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1553 N PORTER AVE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716621",
            "telephone_number": "405-217-8500",
            "fax_number": "405-217-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1553 N PORTER AVE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716621",
            "telephone_number": "405-217-8500",
            "fax_number": "405-217-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUSTIN SHAUN TEDESCO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "TEDESCO",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "405-936-0504",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OK",
            "license": "25729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200206650B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melina Duran
• Kelly L Duren, P.A.
• Kayleigh Durham
• Margaret McKay Durham, LPC AND LMFT
• Sherri Lynn Durica, M.D.
• Chelsey Duthie
• Jacob Thomas Duvall
• Alyson Joy Dykstra, R.D.
• Dylan Roberts DO PLLC (Dylan Roberts DO)
• Maria Eugenia Dyurich

• Nephrology Physician in Norman, OK
• Providers in Norman, OK by specialty
• Nephrology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.