Kenneth David Tricinella, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4144 Issued in OK

Practice address

6128 E 61St St
Tulsa, OK 74136-2117

Phone

(918) 496-8268

Fax

(918) 496-1168

NPI assigned

May 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083661227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6128 E 61ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741362117",
            "telephone_number": "918-496-8268",
            "fax_number": "918-496-1168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6128 E 61ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741362117",
            "telephone_number": "918-496-8268",
            "fax_number": "918-496-1168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRICINELLA",
        "first_name": "KENNETH",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Triad Surgery Center, LLC
• Tribal Bio-Med, LLC
• Lauren Denise Tribbey Lane, M.D.
• Anthony Paul Tricinella, D.O.
• Christopher David Tricinella, D.D.S.
• Lindsey Tricinella, D.O.
• Young Trieu, M.D.
• Leah Trim, RN
• Mark Aaron Trimble, MD
• Trina Inc

• 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.