Henyretta Dental Center 2, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

5868 Issued in OK

Legal business name

HENYRETTA DENTAL CENTER 2, PLLC

Practice address

121 S 6TH St
Henryetta, OK 74437-5009

Phone

(918) 652-2555

Fax

(918) 652-2556

NPI assigned

Aug 9, 2011

Last updated

Aug 9, 2011By 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. Jeremy Scott Johnson, D.D.S.NPI 1316042476

Title

Dentist

Phone

98186522555

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Henryetta Dental Center, PLLC Former legal business name

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.

• Jeremy Scott Johnson, D.D.S.

  • General Practice Dentistry
  • Henryetta, OK
  • NPI 1316042476
  NPD (past) Authorized official
• David Lee Warden, D.D.S.

  • General Practice Dentistry
  • Henryetta, OK
  • NPI 1134213424
  NPD (past)

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1750660700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S 6TH ST",
            "city": "HENRYETTA",
            "state": "OK",
            "postal_code": "744375009",
            "telephone_number": "918-652-2555",
            "fax_number": "918-652-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S 6TH ST",
            "city": "HENRYETTA",
            "state": "OK",
            "postal_code": "744375009",
            "telephone_number": "918-652-2555",
            "fax_number": "918-652-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENYRETTA DENTAL CENTER 2, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-09",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "98186522555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OK",
            "license": "5868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200085770A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henryetta Dental Center, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Henryetta Community Skilled Healthcare and Rehab LLC (Henryetta Community Skilled Healthcare and Rehab)
• Henryetta Dental Center
• Henryetta Drug LLC (Henryetta Drug)
• Henryetta Eye Center
• Henryetta Public Schools
• Heritage Acquisition, LLC (Choice Health at Home - Henryetta Hospice)
• Heritage Acquisition, LLC. (Choice Health at Home - Henryetta Hospice)
• Brandon S Herrscher, DMD
• Tiffany Kristen Hobbs I
• Hometown Healthcare Solution, LLC.

• Dental Clinic/Center in Henryetta, OK
• Providers in Henryetta, OK by specialty
• Dental Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.