Dental Lodge at Brookhave

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5955 Issued in OK

Legal business name

DENTAL LODGE AT BROOKHAVE

Practice address

3700 W Robinson St
Suite 102
Norman, OK 73072-3659

Phone

(405) 872-9597

NPI assigned

Jun 3, 2014

Organization subpart

No

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

Authorized official

Name

Gary D Nabors Jr., D.D.S.

Title

Owner

Phone

(405) 872-9597

Specialties & licenses 1

Addresses

Tax ID family

Brammer Dental PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Brammer Dental PLLC

  • Dentist
  • Norman, OK
  • NPI 1417315276
  NPD tax ID

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1164835617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "city": "NOBLE",
            "state": "OK",
            "postal_code": "730680069",
            "telephone_number": "405-872-9597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W ROBINSON ST",
            "address_2": "SUITE 102",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730723659",
            "telephone_number": "405-872-9597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL LODGE AT BROOKHAVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "NABORS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-872-9597",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Depot of 36TH & Tecumseh, PLLC
• Dental Depot of Norman, PLLC
• Dental Depot Orthodontics Norman PLLC
• Dental Depot Orthodontics Tecumseh, PLLC
• Dental Design Studio
• Dental Professionals Oklahoma, PC (Dental Care of Norman)
• Pamela Sue Denton, RN
• Department of Mental Health and Substance Abuse
• Sabrina Dequasie, LPC
• Derek R Mask DDS PLLC

• General Practice Dentistry in Norman, OK
• Providers in Norman, 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 Jun 3, 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.