Oak Grove Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5630 Issued in LA

Legal business name

OAK GROVE DENTAL

Practice address

414 Ross St
Oak Grove, LA 71263-9727

Phone

(318) 428-4255

NPI assigned

Nov 2, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Robert Vance Costello, DDS

Title

Co Owner

Phone

(318) 428-4255

Specialties & licenses 1

Addresses

Locations

Practitioners 4

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

• Caitlin Lenz, D.D.S.

  • Dentist
  • Norco, LA
  • NPI 1245687912
  NPD (past)
• Ryan Joseph Rachal, DDS

  • General Practice Dentistry
  • Farmerville, LA
  • NPI 1649709791
  NPD (past)
• Karla Welch Robertson, DDS

  • Dentist
  • Oak Grove, LA
  • NPI 1376670059
  NPD (past)
• Allie Elizabeth Watson, DDS

  • General Practice Dentistry
  • Oak Grove, LA
  • NPI 1609369123
  NPD (past)

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288656000000",
    "number": "1225338593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390",
            "city": "OAK GROVE",
            "state": "LA",
            "postal_code": "712630390",
            "telephone_number": "318-428-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 ROSS ST",
            "city": "OAK GROVE",
            "state": "LA",
            "postal_code": "712639727",
            "telephone_number": "318-428-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK GROVE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-02",
        "last_updated": "2010-11-02",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "VANCE",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "318-428-4255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Nicole Moody, RPH
• Candice Moore
• Janet Murry, LMT
• Erin Newton
• Northeast Louisiana Substance Abuse
• Oak Grove Dialysis LLC
• Tony Ray Ogden, APRN
• Sireesha Palkamsetti, M.D
• Perkins Family Pharmacy LLC
• Perkins Health Management LLC

• General Practice Dentistry in Oak Grove, LA
• Providers in Oak Grove, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.