NPIMap

Organization Active NPI

Randi Kennedy Gray, D.D.S., PLLC

  • Dental Clinic/Center
  • Sallisaw, OK
National Provider Identifier
1346735594
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
7056 Issued in OK
Legal business name
RANDI KENNEDY GRAY, D.D.S., PLLC
Practice address
504 E Cherokee Ave
Sallisaw, OK 74955-4842
Phone
(918) 776-0804
NPI assigned
Jun 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Authorized official

Name
Dr. Randi Kennedy Gray, DDSNPI 1841781002
Title
Dentist
Phone
(918) 774-4369

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 7056 OK Primary

Addresses

Primary practice location

504 E Cherokee Ave
Sallisaw, OK 74955-4842

Mailing address

504 E Cherokee Ave
Sallisaw, OK 74955-4842

National Provider Directory

National Provider Directory

Locations

504 E Cherokee Ave
Sallisaw, OK 74955
Phone (918) 774-4369

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530144000000",
    "number": "1346735594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 E CHEROKEE AVE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749554842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 E CHEROKEE AVE",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749554842",
            "telephone_number": "918-776-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDI KENNEDY GRAY, D.D.S., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "RANDI",
        "authorized_official_middle_name": "KENNEDY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "918-774-4369",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OK",
            "license": "7056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sallisaw, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.