NPIMap

Organization Active NPI

Endodontic Specialists of Northeast Ok

  • Endodontics
  • Tulsa, OK
National Provider Identifier
1790951614
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
5644 Issued in OK
Legal business name
ENDODONTIC SPECIALISTS OF NORTHEAST OK
Practice address
5555 E 71St St
Ste 9210
Tulsa, OK 74136-6542
Phone
(918) 524-3366
Fax
(918) 524-3399
NPI assigned
Apr 30, 2008
Last updated
Apr 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Authorized official

Name
Armella Glenn, BS
Title
Office Manager
Phone
(918) 524-3366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 5644 OK Primary

Addresses

Primary practice location

5555 E 71St St
Ste 9210
Tulsa, OK 74136-6542

Mailing address

5555 E 71St St
Ste 9210
Tulsa, OK 74136-6542
Phone (918) 524-3366

National Provider Directory

National Provider Directory

Locations

5555 E 71st St
Ste 9210
Tulsa, OK 74136
Phone (918) 524-3366

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1790951614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 E 71ST ST",
            "address_2": "STE 9210",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366542",
            "telephone_number": "918-524-3366",
            "fax_number": "918-524-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 E 71ST ST",
            "address_2": "STE 9210",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741366542",
            "telephone_number": "918-524-3366",
            "fax_number": "918-524-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTIC SPECIALISTS OF NORTHEAST OK",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "ARMELLA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "918-524-3366",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OK",
            "license": "5644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.