Surat Attaphitaya, DMD
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Ponca City, OK
NPI 1164592259 · NPPES record last updated May 21, 2012
Key facts
- NPI
- 1164592259
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 22054 (TX)
- Practice address
- 900 E Prospect Ave
Ste 800
Ponca City, OK 74601-1600 - Phone
- (580) 765-2000
- Fax
- (580) 765-2001
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22054 | TX | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 54986 | CA | MD | Pharmacist |
| 184 | OK | MD | Podiatrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 54986 | CA | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 184 | OK | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 22054 | TX | Yes |
Addresses
Primary practice location
900 E Prospect Ave
Ste 800
Ponca City, OK 74601-1600
Mailing address
900 E Prospect Ave
Ste 800
Ponca City, OK 74601-1600
Phone (580) 765-2000
Other providers in Ponca City, OK
- Rachel Anstine
- Laurie Scott Appleman
- Shaun Michael Arant
- Craig Vincent Archer
- Amanda Arie
- Avenue of Hope Assoc.
- Rachael Ann Backus
- Taelor Baetz
- Mary E Bahruth-Poskey
- Lionel Everett Bair II
All providers in Ponca City, OK · Orthodontics and Dentofacial Orthopedics Dentistry in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.