Coffee Creek Pediatric Dentistry PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

COFFEE CREEK PEDIATRIC DENTISTRY PLLC

Doing business as

Children's Dentistry of Coffee Creek

Practice address

2800 N Kelly Ave Ste 200
Edmond, OK 73003-3004

Phone

(405) 562-2222

NPI assigned

Nov 23, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie Ferguson, DDSNPI 1881858264

Title

Owner

Phone

(405) 562-2222

Specialties & licenses 1

Addresses

Other names 1

• Children's Dentistry of Coffee Creek Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Marie Ferguson, DDS

  • Pediatric Dentistry
  • Arlington, TX
  • NPI 1881858264
  NPD Authorized official

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637625600000",
    "number": "1689331753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N KELLY AVE STE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730033004",
            "telephone_number": "405-562-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N KELLY AVE STE 200",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730033004",
            "telephone_number": "405-562-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFFEE CREEK PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-23",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-562-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Dentistry of Coffee Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Kathyrn Cockrell, APRN
• Holly Christina Cockrum, M.ED, LPC
• Kyle Dayton Cody
• Crystal Coetzee
• Coffee Creek Family Dentistry
• Caitlin Dakota Coffey, BACHELORS DEGREE
• Zachary Terrell Coffey, BA IN SOCIOLOGY
• Cognitive Transformations
• Lawrence J Cohen, PHARMD, BCPP
• Cohesive Mediryde

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.