Individual provider Active NPI

Kathy L Dehart, DDS

  • General Practice Dentistry
  • Oklahoma City, OK
National Provider Identifier
1710909676
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4924 Issued in OK
Practice address
13400 N Pennsylvania Ave
Oklahoma City, OK 73120
Phone
(405) 418-0888
Fax
(405) 418-0891
NPI assigned
Jul 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4924 OK Primary

Addresses

Primary practice location

13400 N Pennsylvania Ave
Oklahoma City, OK 73120

Mailing address

13400 N Pennsylvania Ave
Oklahoma City, OK 73120
Phone (405) 418-0888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160401000020 OK Order and Referring Only - DentistPractitioner - Dentist 1052618360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aasdg PLLC General Practice PastSince Aug 14, 2022 Accepting new patients
Kathy L. Dunavan Dehart DDS PLLC General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710909676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 N PENNSYLVANIA AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73120",
            "telephone_number": "405-418-0888",
            "fax_number": "405-418-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 N PENNSYLVANIA AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73120",
            "telephone_number": "405-418-0888",
            "fax_number": "405-418-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHART",
        "first_name": "KATHY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.