NPIMap

Organization Active NPI

Ok Specialty Dental Services, PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Yukon, OK
National Provider Identifier
1831914464
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
OK SPECIALTY DENTAL SERVICES, PLLC
Practice address
1600 Garth Brooks Blvd Ste 155
Yukon, OK 73099-7412
Phone
(405) 227-0054
NPI assigned
Nov 19, 2024
Organization subpart
Yes
Parent organization
OK SPECIALTY DENTAL SERVICES, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Charlotte Dasch
Title
Director of Cred and Prov Rel
Phone
(504) 638-0303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

1600 Garth Brooks Blvd Ste 155
Yukon, OK 73099-7412

Mailing address

1610 54TH Ave N Ste 205
Nashville, TN 37209-1442
Phone (615) 678-0759

Other practice location 1

5940 NW Expressway Ste 100
Oklahoma City, OK 73132-5101
Phone (405) 227-0054

Other names 1

  • Red Dirt Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ok Specialty Dental Services PLLC6 organizations share this tax ID, including this one
Part of
Ok Specialty Dental Services PLLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5940 NW Expressway
Ste 100
Oklahoma City, OK 73132
Phone (405) 227-0054

1600 Garth Brooks Blvd
Ste 155
Yukon, OK 73099
Phone (405) 227-0054

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1831914464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 54TH AVE N STE 205",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091442",
            "telephone_number": "615-678-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 GARTH BROOKS BLVD STE 155",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730997412",
            "telephone_number": "405-227-0054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5940 NW Expressway Ste 100",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731325101",
            "country_code": "US",
            "telephone_number": "405-227-0054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OK SPECIALTY DENTAL SERVICES, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OK SPECIALTY DENTAL SERVICES, PLLC",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "DASCH",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "DIRECTOR OF CRED AND PROV REL",
        "authorized_official_telephone_number": "504-638-0303"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Dirt Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yukon, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.