Tracy Ann Gasbarra, DDS
Individual provider Active NPI Dentist · Choctaw, OK
NPI 1740314129 · NPPES record last updated Feb 23, 2022
Key facts
- NPI
- 1740314129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 5671 (OK)
- Practice address
- 2401 N Henney Rd
Choctaw, OK 73020 - Phone
- (405) 390-2000
- Fax
- (405) 390-2018
- NPI assigned
- Mar 15, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5671 | OK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allied Dental Associates of Choctaw PLLC | General Practice | Current |
Accepting new patients |
| Allied Dental Associates of Choctaw PLLC | Current |
Accepting new patients |
Locations
2060 Harper St
Choctaw, OK 73020
Phone (405) 281-6304
2401 N Henney Rd
Choctaw, OK 73020
Phone (405) 390-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5671 | OK | Yes |
Addresses
Primary practice location
2401 N Henney Rd
Choctaw, OK 73020
Mailing address
2401 N Henney Rd
Choctaw, OK 73020
Phone (405) 390-2000
Other providers in Choctaw, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.