Eagle Creek Family Dentistry PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

EAGLE CREEK FAMILY DENTISTRY PLLC

Practice address

4320 McAuley Blvd
Oklahoma City, OK 73120-8386

Phone

(405) 622-5612

NPI assigned

Jun 25, 2018

Organization subpart

No

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

Authorized official

Name

Toni White

Title

Insurance Coordinator

Phone

(405) 844-6333

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529884800000",
    "number": "1306331194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 W COVELL RD STE 160",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730032302",
            "telephone_number": "405-844-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 MCAULEY BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208386",
            "telephone_number": "405-622-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE CREEK FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "TONI",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "405-844-6333"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.