Amy Odessa Brown, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

3612 Issued in OK

Practice address

715 Grandview Ave
Pawhuska, OK 74056-3201

Phone

(918) 287-9300

Fax

(918) 287-3672

NPI assigned

Feb 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amy Odessa Mashburn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1497211619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 GRANDVIEW AVE",
            "city": "PAWHUSKA",
            "state": "OK",
            "postal_code": "740563201",
            "telephone_number": "918-287-9300",
            "fax_number": "918-287-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 GRANDVIEW AVE",
            "city": "PAWHUSKA",
            "state": "OK",
            "postal_code": "740563201",
            "telephone_number": "918-287-9300",
            "fax_number": "918-287-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "AMY",
        "middle_name": "ODESSA",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-12",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OK",
            "license": "3612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "MASHBURN",
            "middle_name": "ODESSA",
            "credential": "RDH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gabriele Dawn Barrone
• Scott Alexander Blackburn, LMSW-P
• Bowring Public School
• Jonathan Brewer, M.D.
• Penny Lynn Britton
• Kamola Bruton
• Adam Bulleigh, D.D.S.
• Kristina Joy Burchett
• Noelle Grace Burnett
• Cori Lynn Butler, PHARMACIST

• Dental Hygienist in Pawhuska, OK
• Providers in Pawhuska, OK by specialty
• Dental Hygienist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.