NPIMap

Organization Active NPI

Premier Dental of Western Oklahoma, PLLC

  • General Practice Dentistry
  • Elk City, OK
National Provider Identifier
1790959757
Registry record updated Apr 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5614 Issued in OK
Legal business name
PREMIER DENTAL OF WESTERN OKLAHOMA, PLLC
Practice address
3102 S Highway 6
Elk City, OK 73644-9779
Phone
(580) 225-4448
Fax
(580) 225-4460
NPI assigned
Apr 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2008

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

Authorized official

Name
Dr. Patrick Pete Stover, DDSNPI 1699703850
Title
Dentist
Phone
(580) 225-4448

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5614 OK Primary

Addresses

Primary practice location

3102 S Highway 6
Elk City, OK 73644-9779

Mailing address

3102 S Highway 6
Elk City, OK 73644-9779
Phone (580) 225-4448

National Provider Directory

National Provider Directory

Locations

3102 S Highway 6
Elk City, OK 73644
Phone (580) 225-4448

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208736000000",
    "number": "1790959757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 S HIGHWAY 6",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736449779",
            "telephone_number": "580-225-4448",
            "fax_number": "580-225-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 S HIGHWAY 6",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736449779",
            "telephone_number": "580-225-4448",
            "fax_number": "580-225-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DENTAL OF WESTERN OKLAHOMA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-21",
        "last_updated": "2008-04-21",
        "status": "A",
        "authorized_official_last_name": "STOVER",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "PETE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "580-225-4448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "5614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.