Children'S Dental Clinic of Oklahoma City at Portland Plaza, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CHILDREN'S DENTAL CLINIC OF OKLAHOMA CITY AT PORTLAND PLAZA, PLLC

Practice address

3637 NW 39TH St
Oklahoma City, OK 73112-6309

Phone

(405) 942-7755

NPI assigned

Jul 4, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Trudy Williams

Title

Director, Licensing & Credentialing

Phone

(615) 750-0342

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Mark T Kelly

  • General Practice Dentistry
  • Oklahoma City, OK
  • NPI 1578656393
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274054400000",
    "number": "1235169129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W 8TH ST",
            "address_2": "SUITE 810",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033038",
            "telephone_number": "719-562-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 NW 39TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731126309",
            "telephone_number": "405-942-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S DENTAL CLINIC OF OKLAHOMA CITY AT PORTLAND PLAZA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2010-05-17",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TRUDY",
        "authorized_official_title_or_position": "DIRECTOR, LICENSING & CREDENTIALING",
        "authorized_official_telephone_number": "615-750-0342",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rajani K Chilakapati, MD
• Child Abuse Response and Evaluation, Inc.
• Crystal Lynn Childers, BSW
• Jesse Cole Childers
• Kristen Ellen Childers
• Children'S Dental Clinic of Oklahoma City, PLLC
• Childrens Eye Care P L L C
• Reshanna Leshae Childs-Russell
• Ebony T Childs
• TG Childs

• 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 May 17, 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.