Organization Active NPI

Implant and Oral Surgery of Colorado PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Oklahoma City, OK
National Provider Identifier
1134447972
Registry record updated May 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
8089 Issued in CO
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, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2010

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)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
02047637MedicaidCO

National Provider Directory

National Provider Directory

Practitioners & 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.

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.

Verify at the official NPI Registry.