Southwest Pediatric Dental Associates, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

4636 Issued in OK

Legal business name

SOUTHWEST PEDIATRIC DENTAL ASSOCIATES, PLLC

Practice address

809 SW 89TH St
Suite a
Oklahoma City, OK 73139-9300

Phone

(405) 616-7336

Fax

(405) 616-5756

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Theresa M. White, DDSNPI 1730205881

Title

Manager

Phone

(405) 616-7336

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Theresa M. White, DDS

  • Pediatric Dentistry
  • Oklahoma City, OK
  • NPI 1730205881
  NPD (past) Authorized official

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366568438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 SW 89TH ST",
            "address_2": "SUITE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399300",
            "telephone_number": "405-616-7336",
            "fax_number": "405-616-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 SW 89TH ST",
            "address_2": "SUITE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399300",
            "telephone_number": "405-616-7336",
            "fax_number": "405-616-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST PEDIATRIC DENTAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-616-7336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OK",
            "license": "4636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southwest Oklahoma MRI, LLC
• Southwest Orthopaedic Specialists, P.L.L.C.
• Southwest Orthopaedic Specialists, PLLC
• Southwest Orthopaedic Specialists, PLLC
• Southwest Orthotic Lab, LLC
• Southwest Pediatrics and Allergy
• Southwest Pediatrics, PLLC
• Southwest Pulmonary & Sleep Consultants
• Southwest Radiation Oncology, Inc
• Southwest Rehabilitation

• Pediatric Dentistry in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Pediatric Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.