Hero Dental of Tulsa PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

HERO DENTAL OF TULSA PC

Doing business as

Adventure Dental of Tulsa

Practice address

4955 S Peoria Ave
Tulsa, OK 74105-0000

Phone

(719) 576-1850

Fax

(719) 576-1929

NPI assigned

Mar 28, 2012

Organization subpart

No

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

Authorized official

Name

Renee Berryhill

Title

Credentialing Specialist

Phone

(719) 576-1850

Specialties & licenses 1

Addresses

Other names 1

• Adventure Dental of Tulsa Doing business as

Locations

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343260800000",
    "number": "1164798757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 N NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031708",
            "telephone_number": "719-576-1850",
            "fax_number": "719-576-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741050000",
            "telephone_number": "719-576-1850",
            "fax_number": "719-576-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERO DENTAL OF TULSA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-07-26",
        "status": "A",
        "authorized_official_last_name": "BERRYHILL",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "719-576-1850"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventure Dental of Tulsa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexandra Herndon, PAC
• Hero Dental of Garnett PC
• Hero Dental of Oklahoma PC
• Hero Dental of Oklahoma PC
• Hero Dental of Oklahoma PC
• Hero Vision of Garnett Plaza PLLC
• Hero Vision of Utica, LLC
• Brandie Herren, RN
• Travis Herren
• Lashauna Herrera Romero

• General Practice Dentistry in Tulsa, OK
• Providers in Tulsa, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; 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.