NPIMap

Organization Active NPI

Dental Professionals of Oklahoma, PC

Doing business as Moore Complete Dental

  • General Practice Dentistry
  • Oklahoma City, OK
National Provider Identifier
1619729704
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF OKLAHOMA, PC
Doing business as
Moore Complete Dental
Practice address
138 SW 134TH St Ste C
Oklahoma City, OK 73170-1490
Phone
(405) 378-5692
Fax
(405) 759-2754
NPI assigned
Apr 3, 2024
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF OKLAHOMA, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Authorized official

Name
Cemyira McDougal
Title
Credentialing Coordinator
Phone
(217) 764-8609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

138 SW 134TH St Ste C
Oklahoma City, OK 73170-1490

Mailing address

138 SW 134TH St Ste C
Oklahoma City, OK 73170-1490
Phone (405) 378-5692

Other names 1

  • Moore Complete Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Health Associates of Texas PC10 organizations share this tax ID, including this one
Part of
Dental Health Associates of Texas PC

Other organizations with this tax ID 9

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

Locations

138 SW 134th St
Ste C
Oklahoma City, OK 73170
Phone (405) 378-5692

NPI Registry JSON

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1619729704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 SW 134TH ST STE C",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731701490",
            "telephone_number": "405-378-5692",
            "fax_number": "405-759-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 SW 134TH ST STE C",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731701490",
            "telephone_number": "405-378-5692",
            "fax_number": "405-759-2754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF OKLAHOMA, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF OKLAHOMA, PC",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "MCDOUGAL",
        "authorized_official_first_name": "CEMYIRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-764-8609"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moore Complete Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.