Dental Depot Mid West City

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3723 Issued in OK

Legal business name

DENTAL DEPOT MID WEST CITY

Practice address

5691 Tinker Diagonal
Midwest City, OK 73110

Phone

(405) 737-5123

Fax

(405) 737-5125

NPI assigned

Jun 13, 2007

Organization subpart

No

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

Authorized official

Name

Beth Grant

Title

Office Manager

Phone

(405) 737-5123

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Taylor Clinton Marcum

  • General Practice Dentistry
  • Midwest City, OK
  • NPI 1740627272
  NPD (past)
• Robert Adrian Stark, D.D.S.

  • Dentist
  • Springdale, AR
  • NPI 1427087352

  General Practice

  NPD (past)

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624579200000",
    "number": "1245434166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 NW 30TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731127404",
            "telephone_number": "405-737-5123",
            "fax_number": "405-737-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5691 TINKER DIAGONAL",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "73110",
            "telephone_number": "405-737-5123",
            "fax_number": "405-737-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL DEPOT MID WEST CITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "405-737-5123"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "3723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deng Family Medicine Center, PC
• Zeming Deng, M.D.
• Chere Denmark
• Denniece Knapp Inc
• Audrea Burnette Denson
• Dentistry by Design
• Desire 2 Be You Counseling Services, LLC
• Diamond Dental, PLLC
• Brandy Dickenson
• Jeffrey Scott Dickey V

• General Practice Dentistry in Midwest City, OK
• Providers in Midwest 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 Jun 25, 2021; 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.