Elk City Dental Group PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ELK CITY DENTAL GROUP PLLC

Practice address

1011 N Main St
Elk City, OK 73644-2830

Phone

(580) 225-1232

NPI assigned

Jul 2, 2019

Organization subpart

No

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

Authorized official

Name

Joshua Brasher, DDS

Title

President

Phone

(405) 474-6362

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562025600000",
    "number": "1245892926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 E COVELL RD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730346909",
            "telephone_number": "405-474-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N MAIN ST",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736442830",
            "telephone_number": "580-225-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK CITY DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A",
        "authorized_official_last_name": "BRASHER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-474-6362",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Duren
• Ashley Brooke Dyson, PA-C
• Connie Edwards
• John D Edwards, O.D.
• Elk City Comforting Hands Hospice LLC
• Elk City Eye Care PLLC
• Elk City Nursing Home LLC
• Elk City Pubic Schools
• Elk City RX Inc
• Elk City RX Inc

• General Practice Dentistry in Elk City, OK
• Providers in Elk 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 Jul 2, 2019; 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.