Dental Lodge, PLC

Primary specialty

DentistTaxonomy code 122300000X

License

5955 Issued in OK

Legal business name

DENTAL LODGE, PLC

Practice address

305A N Main St
Noble, OK 73068-9322

Phone

(405) 872-9597

Fax

(405) 872-5271

NPI assigned

Jan 11, 2010

Last updated

Jan 11, 2010By 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. Gary Dwayne Nabors Jr., D.D.S.NPI 1235333535

Title

Owner

Phone

(405) 872-9597

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Gary D. Nabors Jr., DDS

  • General Practice Dentistry
  • Noble, OK
  • NPI 1235333535
  NPD (past) Authorized official

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1831429042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "city": "NOBLE",
            "state": "OK",
            "postal_code": "730680069",
            "telephone_number": "405-872-9597",
            "fax_number": "405-872-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305A N MAIN ST",
            "city": "NOBLE",
            "state": "OK",
            "postal_code": "730689322",
            "telephone_number": "405-872-9597",
            "fax_number": "405-872-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL LODGE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-11",
        "last_updated": "2010-01-11",
        "status": "A",
        "authorized_official_last_name": "NABORS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "DWAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-872-9597",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "5955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cletas Cottage Day Treatment Center
• Julie Curry, LPC
• Sharri Ann Daily
• William Paul Davidson, LCSW
• Dental Lodge of Noble, PLLC
• Drugs & Things Inc (Noble Pharmacy)
• Jessica Kali Dunlap, PT
• Theodore Anthony Esswein, DDS
• Kevin Jay Faris, M.D.
• James Donald Gilliam, D.D.S.

• Dentist in Noble, OK
• Providers in Noble, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.