Deena Dave, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14395 Issued in OK

Practice address

1202 SW 67TH STR
Suite 2 and 3
Lawton, OK 73505

Phone

(580) 250-0324

Fax

(580) 248-4523

NPI assigned

Sep 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243987200000",
    "number": "1164418356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 S.W 67TH STR.",
            "address_2": "SUITE 2 AND 3",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73505",
            "telephone_number": "580-250-0324",
            "fax_number": "580-248-4523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 SW 67TH STR",
            "address_2": "SUITE 2 AND 3",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73505",
            "telephone_number": "580-250-0324",
            "fax_number": "580-248-4523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "DEENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2009-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "14395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100084210A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rita Daniel, LPC, NCC, LADC
• Nga Dao
• Beth Darbe, M.S., CCC-SLP
• Chelsey Darville
• Daryl E. Birdwell, M.D., Inc.
• Mayank Nandkishor Dave, MD
• Shawn Dave, MD
• Tremell Davenport
• David J Harrell DDS Inc
• David J. Drummond DDS, Inc.

• Family Medicine Physician in Lawton, OK
• Providers in Lawton, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.