Owasso Pediatric Dentistry, PLLC

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

OWASSO PEDIATRIC DENTISTRY, PLLC

Practice address

9455 N Owasso Expy Ste H
Owasso, OK 74055-5457

Phone

(918) 998-0996

NPI assigned

Apr 29, 2024

Organization subpart

No

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

Authorized official

Name

Creed Cardon, DDS

Title

President

Phone

(918) 998-0996

Specialties & licenses 1

Addresses

Other names 1

• Owasso Pediatric Dental Doing business as

Locations

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1750137907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERWALK TER STE 250",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375619",
            "telephone_number": "918-998-0996",
            "fax_number": "918-235-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9455 N OWASSO EXPY STE H",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740555457",
            "telephone_number": "918-998-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OWASSO PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "CARDON",
        "authorized_official_first_name": "CREED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-998-0996",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Owasso Pediatric Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Owasso Medical Facility, Inc
• Owasso Nursing Center, Inc.
• Owasso Orthodontics
• Owasso Pain Management
• Owasso Pediatric and Adolescent Medicine, P.L.C.
• Owasso Periodontics and Dental Implants
• Owasso Public Schools
• Owasso Speech Co LLC
• Owasso Wellness PLLC
• Stephan Owings

• Public Health Dentistry in Owasso, OK
• Providers in Owasso, OK by specialty
• Public Health Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.