Premiere Dentistry of Tahlequah

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PREMIERE DENTISTRY OF TAHLEQUAH

Practice address

1205 E Ross Bypass
Tahlequah, OK 74464

Phone

(918) 456-2555

Fax

(918) 456-2444

NPI assigned

Mar 21, 2006

Organization subpart

No

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

Authorized official

Name

Robert Stephen Jones, DDS

Title

Dentist

Phone

(918) 456-2555

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Premiere Dentistry of Tahlequah2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Premiere Dentistry of Tahlequah, P.C.

  • General Practice Dentistry
  • Tahlequah, OK
  • NPI 1841465861
  NPD tax ID

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270512000000",
    "number": "1245299825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 E ROSS BYPASS",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "74464",
            "telephone_number": "918-456-2555",
            "fax_number": "918-456-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 E ROSS BYPASS",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "74464",
            "telephone_number": "918-456-2555",
            "fax_number": "918-456-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE DENTISTRY OF TAHLEQUAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2010-04-06",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "918-456-2555",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200021320",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandy Ponder, APRN
• Amanda Post
• William Ray Potts, D. PH.
• Gena Powers
• Charles Pradieu, M.D.
• Premiere Dentistry of Tahlequah, P.C.
• Premiere Family Dentistry of Tahlequah, PLLC
• Jesse Lee Price, LCSW
• Prime Medical Outlet LLC
• Billi Jayne Prinzen, O.D.

• General Practice Dentistry in Tahlequah, OK
• Providers in Tahlequah, 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 Apr 6, 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.