NPIMap

Organization Active NPI

Green Country Denture Center

Doing business as Premier Dentures & Implants

  • Dentist
  • Bartlesville, OK
National Provider Identifier
1215080734
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5431 Issued in OK
Legal business name
GREEN COUNTRY DENTURE CENTER
Doing business as
Premier Dentures & Implants
Practice address
1824 S.E . Washington Blvd.
Bartlesville, OK 74006
Phone
(918) 331-2221
Fax
(918) 336-1052
NPI assigned
Jan 19, 2007
Last updated
Jun 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Authorized official

Name
Dr. John Lard, DDS
Title
President
Phone
(918) 331-2221

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 5431 OK Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 5779 OK

Addresses

Primary practice location

1824 S.E . Washington Blvd.
Bartlesville, OK 74006

Mailing address

1824 S.E . Washington Blvd.
PO Box 3248
Bartlesville, OK 74006
Phone (918) 331-2221

Other names 1

  • Premier Dentures & Implants Doing business as

National Provider Directory

National Provider Directory

Locations

1824 SE Washington Blvd
Bartlesville, OK 74006
Phone (918) 331-2221

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340668800000",
    "number": "1215080734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 S.E . WASHINGTON BLVD.",
            "address_2": "PO BOX 3248",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "74006",
            "telephone_number": "918-331-2221",
            "fax_number": "918-336-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 S.E . WASHINGTON BLVD.",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "74006",
            "telephone_number": "918-331-2221",
            "fax_number": "918-336-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN COUNTRY DENTURE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2012-06-26",
        "status": "A",
        "authorized_official_last_name": "LARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-331-2221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "5431",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "5779",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Dentures & Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bartlesville, OK

Sources for this page

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