Dental Surgery Center of Edmond

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL SURGERY CENTER OF EDMOND

Practice address

13912 N Western Ave
Edmond, OK 73013-1792

Phone

(405) 437-0622

NPI assigned

Jan 15, 2020

Organization subpart

No

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

Authorized official

Name

Benjamin Bowman

Title

Owner

Phone

(405) 326-8004

Specialties & licenses 1

Addresses

Other names 1

• Edmond Dental Surgery Center Doing business as

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610582400000",
    "number": "1386284552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13912 N WESTERN AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13912 N WESTERN AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131792",
            "telephone_number": "405-437-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SURGERY CENTER OF EDMOND",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-15",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-326-8004"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edmond Dental Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bailey Kathleen Dent, FNP
• Dental Facial Imaging LLC
• Dental Inspirations LLC
• Dental Professionals of Ok, PC
• Dental Specialists of Edmond
• Elisa Depani-Sparkes, D.O.
• Julissa Depe, M.S, CCC-SLP
• Stephanie Dequasie
• Nidhi Desai-Pandya, APRN, FNP-C
• Margaret Tarr Deshazer, MS, RD/LD

• Dental Clinic/Center in Edmond, OK
• Providers in Edmond, OK by specialty
• Dental Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.