NPIMap

Organization Active NPI

Crocodile Smiles Children'S Dentistry, PLLC

  • Pediatric Dentistry
  • Oklahoma City, OK
National Provider Identifier
1710165873
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
073 Issued in OK
Legal business name
CROCODILE SMILES CHILDREN'S DENTISTRY, PLLC
Practice address
828 SW 66TH St
Oklahoma City, OK 73139-4213
Phone
(405) 636-1616
NPI assigned
Jan 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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

Authorized official

Name
Dr. Elizabeth KellnerNPI 1760521934
Title
Owner
Phone
(405) 636-1616

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 073 OK Primary

Addresses

Primary practice location

828 SW 66TH St
Oklahoma City, OK 73139-4213

Mailing address

828 SW 66TH St
Oklahoma City, OK 73139-4213

National Provider Directory

National Provider Directory

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": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201737600000",
    "number": "1710165873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 SW 66TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731394213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 SW 66TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731394213",
            "telephone_number": "405-636-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROCODILE SMILES CHILDREN'S DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-01-31",
        "status": "A",
        "authorized_official_last_name": "KELLNER",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-636-1616",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OK",
            "license": "073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 31, 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.