Dental Depot of I-44 & Harvard, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

3723 Issued in OK

Legal business name

DENTAL DEPOT OF I-44 & HARVARD, PLLC

Practice address

4770 S. Harvard Ave.
Tulsa, OK 74135-3024

Phone

(918) 742-2123

Fax

(918) 742-2124

NPI assigned

Sep 26, 2017

Organization subpart

No

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

Authorized official

Name

Glenn Allan Ashmore, DDS

Title

President / Owner

Phone

(918) 742-2123

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1548779135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 NW 30TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731127404",
            "telephone_number": "918-742-2123",
            "fax_number": "918-742-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 S. HARVARD AVE.",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741353024",
            "telephone_number": "918-742-2123",
            "fax_number": "918-742-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL DEPOT OF I-44 & HARVARD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-26",
        "last_updated": "2022-07-21",
        "certification_date": "2021-06-25",
        "status": "A",
        "authorized_official_last_name": "ASHMORE",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "918-742-2123",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "3723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.