Active NPI
Implant and Oral Surgery of Colorado PLLC
- Oral and Maxillofacial Surgery (Dentist)
- Oklahoma City, OK
National Provider Identifier
1134447972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 8089
- Legal business name
- IMPLANT AND ORAL SURGERY OF COLORADO PLLC
- Practice address
- 3000 United Founders Blvd
Ste 237
Oklahoma City, OK 73112-3958 - Phone
- (405) 848-7974
- Fax
- (405) 848-0033
- NPI assigned
- May 4, 2010
- Last updated
- May 4, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kathy Dresher
- Title
- VP of Billing
- Phone
- (405) 848-7974
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 8089 | CO | Primary |
Addresses
Primary practice location
3000 United Founders Blvd
Ste 237
Oklahoma City, OK 73112-3958
Mailing address
755 S Perry St
Ste 300
Castle Rock, CO 80104-1901
Phone (303) 660-5651
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02047637 | Medicaid | CO |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Oral & Maxillofacial Surgery (D.M.D.)
- Castle Rock, CO
- NPI 1740600493
Oral and Maxillofacial Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272931200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1272931200000",
"number": "1134447972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 S PERRY ST",
"address_2": "STE 300",
"city": "CASTLE ROCK",
"state": "CO",
"postal_code": "801041901",
"telephone_number": "303-660-5651",
"fax_number": "303-660-1582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 UNITED FOUNDERS BLVD",
"address_2": "STE 237",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731123958",
"telephone_number": "405-848-7974",
"fax_number": "405-848-0033"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IMPLANT AND ORAL SURGERY OF COLORADO PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-05-04",
"last_updated": "2010-05-04",
"status": "A",
"authorized_official_last_name": "DRESHER",
"authorized_official_first_name": "KATHY",
"authorized_official_title_or_position": "VP OF BILLING",
"authorized_official_telephone_number": "405-848-7974"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CO",
"license": "8089",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02047637",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.