Active NPI
Kayla-Ann Nittler
- General Practice Dentistry
- Edmond, OK
National Provider Identifier
1386375137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7585
- Practice address
- 1617 E Danforth Rd
Edmond, OK 73034-3103 - Phone
- (405) 330-5458
- NPI assigned
- Jun 22, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7585 | OK | Primary |
Addresses
Primary practice location
1617 E Danforth Rd
Edmond, OK 73034-3103
Mailing address
3124 Ash Grove Rd
Edmond, OK 73003-1044
Phone (405) 920-8446
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7585 | OK | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Philip M Gray, DDS, PLLC | Current | Accepting new patients |
Locations
1617 E Danforth Rd
Edmond, OK 73034
Phone (405) 330-5458
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dental Clinic/Center
- Edmond, OK
- NPI 1134845712
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655856000000",
"number": "1386375137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3124 ASH GROVE RD",
"city": "EDMOND",
"state": "OK",
"postal_code": "730031044",
"telephone_number": "405-920-8446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1617 E DANFORTH RD",
"city": "EDMOND",
"state": "OK",
"postal_code": "730343103",
"telephone_number": "405-330-5458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NITTLER",
"first_name": "KAYLA-ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-22",
"last_updated": "2022-06-22",
"certification_date": "2022-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OK",
"license": "7585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.