NPIMap

Organization Active NPI

PKL Orthodontics, PC

  • Dental Clinic/Center
  • Moore, OK
National Provider Identifier
1104206887
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
189 Issued in OK
Legal business name
PKL ORTHODONTICS, PC
Practice address
717 S I 35 Service Rd Ste C
Moore, OK 73160-3190
Phone
(405) 378-4774
NPI assigned
Jun 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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

Authorized official

Name
Dr. Priscilla Pickens-Larson, DMDNPI 1396945358
Title
Owner/ Orthodontist
Phone
(405) 378-4774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 189 OK Primary

Addresses

Primary practice location

717 S I 35 Service Rd Ste C
Moore, OK 73160-3190

Mailing address

717 S I 35 Service Rd Ste C
Moore, OK 73160-3190
Phone (405) 378-4774

Other names 1

  • Sky Ortho Doing business as

National Provider Directory

National Provider Directory

Locations

717 S I 35 Service Rd
Ste C
Moore, OK 73160
Phone (405) 378-4774

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1104206887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 S I 35 SERVICE RD STE C",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731603190",
            "telephone_number": "405-378-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S I 35 SERVICE RD STE C",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731603190",
            "telephone_number": "405-378-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PKL ORTHODONTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-08",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "PICKENS-LARSON",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_title_or_position": "OWNER/ ORTHODONTIST",
        "authorized_official_telephone_number": "405-378-4774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OK",
            "license": "189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sky Ortho",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.

Verify at the official NPI Registry.