Courtney Pendergraft, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

3602 Issued in OK

Practice address

19600 E Ross St
Tahlequah, OK 74464-0545

Phone

(539) 234-2800

NPI assigned

Jun 9, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1285529669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4430 HIGHWAY 412",
            "city": "ROSE",
            "state": "OK",
            "postal_code": "743641677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19600 E ROSS ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744640545",
            "telephone_number": "539-234-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRAFT",
        "first_name": "COURTNEY",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OK",
            "license": "3602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathanael Patron, OD
• Joby Gene Patterson
• Karen Patterson I, PH.D. CCC-SLP/A
• Sarah Anne Pearson, DO
• Fredrick J Pembroke, OD
• Douglas Penisten, OD
• Meghan Pennington, APRN
• People Inc. of Sequoyah Co
• Roberta Lee Perdue
• Dante Perez, MD

• Dental Hygienist in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Dental Hygienist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.