NPIMap

Organization Active NPI

Pediatric Dental Associates PC

  • Dentist
  • Ardmore, OK
National Provider Identifier
1447328349
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PEDIATRIC DENTAL ASSOCIATES PC
Practice address
1103 Walnut Drive
Pediatric Dental Associates PC
Ardmore, OK 73401
Phone
(580) 226-6290
Fax
(580) 223-4381
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Authorized official

Name
Dr. Eugene A Litteken, DDSNPI 1558451971
Title
President
Phone
(580) 226-6290

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1103 Walnut Drive
Pediatric Dental Associates PC
Ardmore, OK 73401

Mailing address

1103 Walnut Drive
Pediatric Dental Associates PC
Ardmore, OK 73401
Phone (580) 226-6290

Other identifiers 1

IdentifierTypeStateIssuer
100182220CMedicaidOK

National Provider Directory

National Provider Directory

Locations

1103 Walnut Dr
Ardmore, OK 73401
Phone (580) 226-6290

Practitioners & affiliated clinicians

Practitioners 3

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": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372377600000",
    "number": "1447328349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 WALNUT DRIVE",
            "address_2": "PEDIATRIC DENTAL ASSOCIATES PC",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "73401",
            "telephone_number": "580-226-6290",
            "fax_number": "580-223-4381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 WALNUT DRIVE",
            "address_2": "PEDIATRIC DENTAL ASSOCIATES PC",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "73401",
            "telephone_number": "580-226-6290",
            "fax_number": "580-223-4381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2013-06-28",
        "status": "A",
        "authorized_official_last_name": "LITTEKEN",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-226-6290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100182220C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; 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.