Active NPI
Suzetta Olunwa, DMD
- Dentist
- Oklahoma City, OK
National Provider Identifier
1073804670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6674
- Practice address
- 201 S Macarthur Blvd
Oklahoma City, OK 73128-1006 - Phone
- (405) 789-3750
- NPI assigned
- Apr 29, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6674 | OK | Primary |
| Dentist | 122300000X | 056112-1 | NY | |
| Dentist | 122300000X | 30531 | TX |
Addresses
Primary practice location
201 S Macarthur Blvd
Oklahoma City, OK 73128-1006
Mailing address
201 S Macarthur Blvd
Oklahoma City, OK 73128
Phone (405) 789-3750
Other names 1
- Suzetta Nash
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30531 | TX | MD | Clinical Psychologist |
| 056112-1 | NY | MD | Dentist |
| 6674 | OK | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ronald Montgomery Dental Group, PC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Gentle Dental Westgate
- Dentist
- Oklahoma City, OK
- NPI 1932396769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424131200000",
"number": "1073804670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 S MACARTHUR BLVD",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "73128",
"telephone_number": "405-789-3750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 S MACARTHUR BLVD",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731281006",
"telephone_number": "405-789-3750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLUNWA",
"first_name": "SUZETTA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-29",
"last_updated": "2015-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "6674",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "056112-1",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "30531",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUZETTA",
"last_name": "NASH",
"credential": "DMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.