Dungarvin Oklahoma LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

100631340G Issued in OK

Legal business name

DUNGARVIN OKLAHOMA LLC

Practice address

9210 S Western Ave Ste a-22
Oklahoma City, OK 73139-4982

Phone

(405) 759-2611

Fax

(405) 759-2650

NPI assigned

Nov 21, 2006

Organization subpart

Yes

Parent organization

DUNGARVIN GROUP, INC.As reported in NPPES

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

Authorized official

Name

Lori Kress

Title

Ceo

Phone

(651) 699-0206

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Dungarvin Oklahoma LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Dungarvin Oklahoma LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Oklahoma City, OK
  • NPI 1174698849
  NPD tax ID
• Dungarvin Oklahoma LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Oklahoma City, OK
  • NPI 1265507933
  NPD tax ID
• Dungarvin Oklahoma LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Oklahoma City, OK
  • NPI 1356416028
  NPD tax ID
• Dungarvin Oklahoma LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Oklahoma City, OK
  • NPI 1982773107
  NPD tax ID

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1083789754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 NORTHLAND DR STE 200",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201032",
            "telephone_number": "651-699-0206",
            "fax_number": "651-699-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9210 S WESTERN AVE STE A-22",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731394982",
            "telephone_number": "405-759-2611",
            "fax_number": "405-759-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNGARVIN OKLAHOMA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DUNGARVIN GROUP, INC.",
        "enumeration_date": "2006-11-21",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "KRESS",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-699-0206"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OK",
            "license": "100631340G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHCA PROVIDER ID",
            "identifier": "100631340G",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsey Duncan, MS, RD, LD
• Mary Elizabeth Duncan, DPH
• Michael Robert Duncan, M.D.
• Rachel Janette Duncan, D.C.
• Brianne Joella Dunford, PA
• Dungarvin Oklahoma LLC
• Dungarvin Oklahoma LLC
• Dungarvin Oklahoma LLC
• Dungarvin Oklahoma LLC
• Dungarvin Oklahoma LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; 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.