Hero Dental of Okc PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HERO DENTAL OF OKC PC

Doing business as

Adventure Dental, Vision and Orthodontics

Practice address

4836 NW 23Rd St
Oklahoma City, OK 73127-1809

Phone

(719) 576-1850

NPI assigned

Dec 5, 2019

Organization subpart

No

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

Authorized official

Name

Shaun Urbanozo

Title

Credentialing Manager

Phone

(719) 576-1850

Specialties & licenses 1

Addresses

Other names 1

• Adventure Dental, Vision and Orthodontics Doing business as

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575504000000",
    "number": "1124665401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 E BIJOU ST STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809098009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4836 NW 23RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731271809",
            "telephone_number": "719-576-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERO DENTAL OF OKC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-05",
        "last_updated": "2019-12-05",
        "status": "A",
        "authorized_official_last_name": "URBANOZO",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "719-576-1850"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventure Dental, Vision and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brittany Herndon, LMSW
• Ella Nicole Herndon, RN
• Jill Wahouske Herndon, AU.D., CCC-A
• Michael Wayne Herndon, DO
• Stephanie Dawn Herndon
• Hero Dental of South Oklahoma City (Adventure Dental Vision and Orthodontics)
• Hero Vision of Okc PLLC (Adventure Dental, Vision and Orthodontics)
• Alexys Ann Herren
• Cherie L Herren, MD
• Stephen W Herren, DDS

• General Practice Dentistry in Oklahoma City, OK
• Providers in Oklahoma City, 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 Dec 5, 2019; 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.