Individual provider Active NPI

Melinda Lea Ahrend, D.D.S

  • Dentist
  • Konawa, OK
National Provider Identifier
1154515690
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5982 Issued in OK
Practice address
527 W 3Rd St
Konawa, OK 74849-1415
Phone
(580) 925-3286
Fax
(580) 925-2362
NPI assigned
Aug 28, 2007
Last updated
Aug 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5982 OK Primary

Addresses

Primary practice location

527 W 3Rd St
Konawa, OK 74849-1415

Mailing address

3707 W 108TH CT
Sapulpa, OK 74066-1815
Phone (918) 518-6595

Other practice location 1

31870 East Hwy 51
Coweta, OK 74429
Phone (918) 279-3200

Other names 1

  • Mindy Lea Boatwright Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250501000509 OK Practitioner - Dentist 2365968401 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5982OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Oklahoma Family Medical Center, Inc CurrentSince Mar 1, 2025 Accepting new patients
Central Oklahoma Family Medical Center Inc CurrentSince Mar 1, 2025 Accepting new patients
Central Oklahoma Family Medical Center, Inc. Current Accepting new patients

Locations

1221 Arlington St
Ste B
Ada, OK 74820
Phone (580) 332-4700

527 W 3rd St
Konawa, OK 74849
Phone (580) 925-3286

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1154515690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 W 108TH CT",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740661815",
            "telephone_number": "918-518-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 W 3RD ST",
            "city": "KONAWA",
            "state": "OK",
            "postal_code": "748491415",
            "telephone_number": "580-925-3286",
            "fax_number": "580-925-2362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31870 East Hwy 51",
            "address_purpose": "LOCATION",
            "city": "Coweta",
            "state": "OK",
            "postal_code": "74429",
            "country_code": "US",
            "telephone_number": "918-279-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHREND",
        "first_name": "MELINDA",
        "middle_name": "LEA",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "5982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINDY",
            "last_name": "BOATWRIGHT",
            "middle_name": "LEA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Konawa, OK

Sources for this page

Verify at the official NPI Registry.