Eastern Oklahoma Dental Institute

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5301 Issued in OK

Legal business name

EASTERN OKLAHOMA DENTAL INSTITUTE

Practice address

5196 S Yale Ave
Tulsa, OK 74135-7432

Phone

(918) 664-1888

Fax

(918) 664-9037

NPI assigned

Oct 25, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Eric Wayne Wyatt, DDSNPI 1326153644

Title

President

Phone

(918) 664-1888

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eric Wayne Wyatt, DDS

  • Dentist
  • Tulsa, OK
  • NPI 1326153644
  NPD (past) Authorized official
• Rebecca Ann Wyatt, DDS

  • Dentist
  • Tulsa, OK
  • NPI 1154436475
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730264433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3040",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740133040",
            "telephone_number": "918-664-1888",
            "fax_number": "918-664-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5196 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741357432",
            "telephone_number": "918-664-1888",
            "fax_number": "918-664-9037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN OKLAHOMA DENTAL INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-664-1888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela M Easter, MS, LPC
• Phillip William Easterly, PT
• Eastern Oklahoma Center for Women Inc
• Eastern Oklahoma Chiropractic, PLLC
• Eastern Oklahoma Dental Anesthesia Specialists, LLC
• Eastern Oklahoma Ear Nose and Throat Inc
• Eastern Oklahoma Ear, Nose & Throat Inc
• Eastern Oklahoma Ear, Nose, and Throat
• Eastern Oklahoma Orthopedic Center Inc
• Eastern Oklahoma Surgery Center LLC

• General Practice Dentistry in Tulsa, OK
• Providers in Tulsa, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.