North Park Family Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

NORTH PARK FAMILY DENTAL

Practice address

301 S Boulevard Ste 118
Edmond, OK 73034-3880

Phone

(405) 348-9182

NPI assigned

Nov 8, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Brad Nelson

Title

Owner

Phone

(405) 260-6080

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ferris Kalidy, DDS

  • Dentist
  • Edmond, OK
  • NPI 1669265864
  NPD
• Randolph Lynn Clark, DDS

  • General Practice Dentistry
  • Edmond, OK
  • NPI 1649347097
  NPD (past)
• Matthew Nguyen, DDS

  • General Practice Dentistry
  • Oklahoma City, OK
  • NPI 1366172595
  NPD (past)

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1174168678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S BOULEVARD STE 118",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730343880",
            "telephone_number": "405-348-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S BOULEVARD STE 118",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730343880",
            "telephone_number": "405-348-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH PARK FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-08",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-260-6080",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Norris, BSM, CPM, LM
• Destiny Lynn Norsworthy
• North Canadian River Healthcare LLC
• North Oklahoma County Mental Health Center
• North Oklahoma County Mental Health Center
• Caysie North
• Lauren Alison Northcutt, MS, RD/LD
• Jolina N Northington, NP
• Northland Hearing Centers, Inc.
• Northwest Physical Therapy Clinic Inc

• Dental Clinic/Center in Edmond, OK
• Providers in Edmond, OK by specialty
• Dental Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.