Southridge Dental Arts PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOUTHRIDGE DENTAL ARTS PLLC

Practice address

8383 S Pennsylvania Ave
Oklahoma City, OK 73159-5249

Phone

(405) 474-6362

NPI assigned

Sep 19, 2018

Last updated

Sep 19, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joshua Brasher, DDS

Title

Owner

Phone

(405) 474-6362

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537315200000",
    "number": "1174007736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 E COVELL RD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346909",
            "telephone_number": "405-474-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8383 S PENNSYLVANIA AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731595249",
            "telephone_number": "405-474-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHRIDGE DENTAL ARTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A",
        "authorized_official_last_name": "BRASHER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-474-6362",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Oklahoma City, OK
• Providers in Oklahoma City, 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 Sep 19, 2018; 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.