NPIMap

Organization Active NPI

Affordable Dentures-Midwest City, P.C.

  • Dentist
  • Del City, OK
National Provider Identifier
1164834701
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4410 Issued in OK
Legal business name
AFFORDABLE DENTURES-MIDWEST CITY, P.C.
Practice address
5301 Main Street
Suite 111
Del City, OK 73115
Phone
(405) 672-0214
Fax
(405) 672-0226
NPI assigned
Jun 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Authorized official

Name
Dr. Richard L. Fentem Jr., DDS
Title
Owner
Phone
(405) 672-0214

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 4410 OK Primary

Addresses

Primary practice location

5301 Main Street
Suite 111
Del City, OK 73115

Mailing address

5301 Main Street
Suite 111
Del City, OK 73115
Phone (405) 672-0214

National Provider Directory

National Provider Directory

Locations

5301 Main St
Ste 111
Del City, OK 73115
Phone (405) 672-0214

NPI Registry JSON

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1164834701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 MAIN STREET",
            "address_2": "SUITE 111",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "73115",
            "telephone_number": "405-672-0214",
            "fax_number": "405-672-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 MAIN STREET",
            "address_2": "SUITE 111",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "73115",
            "telephone_number": "405-672-0214",
            "fax_number": "405-672-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTURES-MIDWEST CITY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-02",
        "last_updated": "2014-06-02",
        "status": "A",
        "authorized_official_last_name": "FENTEM",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-672-0214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "4410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Del City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; 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.