Pediatric Dentistry of Oklahoma

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEDIATRIC DENTISTRY OF OKLAHOMA

Practice address

3613 NW 56TH St Ste 105
Oklahoma City, OK 73112-4520

Phone

(405) 946-2455

Fax

(405) 946-3445

NPI assigned

May 20, 2021

Organization subpart

No

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

Authorized official

Name

Robin S Murphy

Title

Office Manager

Phone

(405) 946-2455

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1629643903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3613 NW 56TH ST STE 105",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124520",
            "telephone_number": "405-946-2455",
            "fax_number": "405-946-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3613 NW 56TH ST STE 105",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124520",
            "telephone_number": "405-946-2455",
            "fax_number": "405-946-3445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2828 Parklawn Dr",
            "address_purpose": "LOCATION",
            "city": "Midwest City",
            "state": "OK",
            "postal_code": "731104216",
            "country_code": "US",
            "telephone_number": "405-733-3553",
            "fax_number": "405-733-5002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF OKLAHOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "405-946-2455"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1184868960",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100122730A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1720063225",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel J Peck, P.A.-C
• Zane Pedersen, MD
• Lars Pederson
• Pediatric Anesthesia of Oklahoma, PLLC
• Pediatric Dental Partners PLLC
• Pediatric ENT of Oklahoma PLLC
• Pediatric Intensive Care Services Inc
• Pediatric Multispecialty Group PLLC
• Pediatric Neuropsychology Associates PLLC
• Pediatrix Medical Group of Oklahoma, P.C.

• Pediatric Dentistry in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Pediatric Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.