NPIMap

Organization Active NPI

Joseph B. Otto DDS, P.C.

  • Dentist
  • Ponca City, OK
National Provider Identifier
1578748547
Registry record updated Jan 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4550 Issued in OK
Legal business name
JOSEPH B. OTTO DDS, P.C.
Practice address
400 Fairview Ave Ste 1
Ponca City, OK 74601-1910
Phone
(580) 765-6633
Fax
(580) 765-0803
NPI assigned
Jan 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2008

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

Authorized official

Name
Joseph Balzer Otto, D.D.S.NPI 1710064910
Title
Owner
Phone
(580) 765-6633

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 4550 OK Primary

Addresses

Primary practice location

400 Fairview Ave Ste 1
Ponca City, OK 74601-1910

Mailing address

400 Fairview Ave Ste 1
Ponca City, OK 74601-1910
Phone (580) 765-6633

National Provider Directory

National Provider Directory

Locations

400 Fairview Ave
Ste 1
Ponca City, OK 74601
Phone (580) 765-6633

Practitioners & affiliated clinicians

Practitioners 1

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": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199750400000",
    "number": "1578748547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FAIRVIEW AVE STE 1",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011910",
            "telephone_number": "580-765-6633",
            "fax_number": "580-765-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FAIRVIEW AVE STE 1",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746011910",
            "telephone_number": "580-765-6633",
            "fax_number": "580-765-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH B. OTTO DDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2008-01-08",
        "status": "A",
        "authorized_official_last_name": "OTTO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "BALZER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-765-6633",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "4550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponca City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; 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.