Dynamic Prosthetics

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

44 Issued in OK

Legal business name

DYNAMIC PROSTHETICS

Practice address

7718 E 91St St Ste 160
Tulsa, OK 74133-6051

Phone

(918) 994-4880

Fax

(918) 994-4885

NPI assigned

Apr 7, 2008

Organization subpart

No

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

Authorized official

Name

Mark A Chimento, LPO, CP

Title

Owner

Phone

(918) 994-4880

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1730352147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7718 E 91ST ST STE 160",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741336051",
            "telephone_number": "918-994-4880",
            "fax_number": "918-994-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7718 E 91ST ST STE 160",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741336051",
            "telephone_number": "918-994-4880",
            "fax_number": "918-994-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PROSTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "CHIMENTO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-994-4880",
        "authorized_official_credential": "LPO, CP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OK",
            "license": "44",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100812540A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin R. Dyer, DO
• Steven Rance Dyer, D.O.
• Zachary Hampton Marler Dyer
• Elizabeth Dygert
• Aubrey Dykes
• Jozef Dzurilla, D.O
• E Bradley Garber, M.D., P.C.
• E Plus Pet Imaging VI LP
• Melissa Eads
• Zoe Eager

• Prosthetic/Orthotic Supplier in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Prosthetic/Orthotic Supplier in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.