NPIMap

Organization Active NPI

Utica Family Dentistry PLLC

  • General Practice Dentistry
  • Tulsa, OK
National Provider Identifier
1114538063
Registry record updated Aug 13, 2020
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
UTICA FAMILY DENTISTRY PLLC
Practice address
1720 S Utica Ave
Tulsa, OK 74104-5318
Phone
(918) 712-0000
NPI assigned
Aug 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Authorized official

Name
Faith Gaskins
Title
Director of Credentialing
Phone
(972) 869-3789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1720 S Utica Ave
Tulsa, OK 74104-5318

Mailing address

1720 S Utica Ave
Tulsa, OK 74104-5318
Phone (918) 712-0000

Other names 1

  • Utica Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1720 S Utica Ave
Tulsa, OK 74104
Phone (918) 712-0000

NPI Registry JSON

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597276800000",
    "number": "1114538063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045318",
            "telephone_number": "918-712-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 S UTICA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045318",
            "telephone_number": "918-712-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTICA FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A",
        "authorized_official_last_name": "GASKINS",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Utica Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; 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.