Board of Regents of Ok - Col of Dentistry Grad Perodontics

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

BOARD OF REGENTS OF OK - COL OF DENTISTRY GRAD PERODONTICS

Doing business as

Col of Dentistry Grad

Practice address

1201 N Stonewall Ave RM Dcs253
Oklahoma City, OK 73117-1214

Phone

(405) 271-6531

Fax

(405) 271-2922

NPI assigned

Apr 2, 2012

Last updated

Apr 2, 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

Lisa Asch

Title

Associate Director Resarch Admin

Phone

(405) 271-2090

Specialties & licenses 1

Addresses

Other names 1

• Col of Dentistry Grad Doing business as

Locations

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1609142827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26901",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731260901",
            "telephone_number": "405-271-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N STONEWALL AVE RM DCS253",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171214",
            "telephone_number": "405-271-6531",
            "fax_number": "405-271-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF REGENTS OF OK - COL OF DENTISTRY GRAD PERODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "ASCH",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR RESARCH ADMIN",
        "authorized_official_telephone_number": "405-271-2090"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Col of Dentistry Grad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Periodontics in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Periodontics in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.