Prestige Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PRESTIGE DENTAL, PLLC

Practice address

10010 E 81St St Ste 200
Tulsa, OK 74133-4561

Phone

(918) 494-8666

Fax

(918) 494-6702

NPI assigned

May 30, 2024

Last updated

May 30, 2024By 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

Cardon Creed

Title

President

Phone

(918) 998-0996

Specialties & licenses 1

Addresses

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.

• Colby Troy Broadbent, DDS

  • General Practice Dentistry
  • Oklahoma City, OK
  • NPI 1558882548
  NPD (past)

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1083454607",
    "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": "10010 E 81ST ST STE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334561",
            "telephone_number": "918-494-8666",
            "fax_number": "918-494-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "CREED",
        "authorized_official_first_name": "CARDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-998-0996"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Presence Nemt
• Gabriel Presley, MD
• Jeremy Nathaniel Presley
• Richard I Presley, OD
• Samuel James Presley, O.D.
• Lynn M. Preston, DO
• Tyler R Preston, BA
• Prevailing Passions Counseling
• Chandra Prevost
• Alexander Gabriel Price, MS, LPC

• General Practice Dentistry in Tulsa, OK
• Providers in Tulsa, 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 May 30, 2024; 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.