Modern Dental Professionals - Oklahoma PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MODERN DENTAL PROFESSIONALS - OKLAHOMA PC

Practice address

13710 N Pennsylvania Ave
Ste. #1
Oklahoma City, OK 73134-6030

Phone

(972) 212-8135

NPI assigned

Jun 4, 2012

Last updated

Jun 4, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Peek, DDS

Title

PC Owner/Dentist

Phone

(972) 212-8135

Specialties & licenses 1

Addresses

Other names 1

• Monarch Dental - Qual Springs Other name

Tax ID family

Modern Dental Professionals Oklahoma PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Modern Dental Professionals, Oklahoma P.C.

  dba Monarch Dental

  • General Practice Dentistry
  • Plano, TX
  • NPI 1285923193
  NPD tax ID

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338768000000",
    "number": "1457612798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 WINDCREST DR STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243087",
            "telephone_number": "972-212-8135",
            "fax_number": "972-767-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13710 N PENNSYLVANIA AVE",
            "address_2": "STE. #1",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731346030",
            "telephone_number": "972-212-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL PROFESSIONALS - OKLAHOMA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-04",
        "last_updated": "2012-06-04",
        "status": "A",
        "authorized_official_last_name": "PEEK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PC OWNER/DENTIST",
        "authorized_official_telephone_number": "972-212-8135",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monarch Dental - Qual Springs",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Raymond Reeves Mobley II, M.D.
• Moc Medical Group PLLC
• Jenna Christine Mock, PA
• Rachel Michelle Mock
• Mrinalini Modak, M.D.
• Moderncare Medical Equipment & Supply LLC
• Ankur Mody, MD
• Katelyn Moeder, MD
• Abby Michelle Moeller, PA-C
• Micah Moeller, MPT

• General Practice Dentistry in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2012; 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.