Red Dirt Orthodontics PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RED DIRT ORTHODONTICS PLLC

Practice address

5940 NW Expressway # 100
Oklahoma City, OK 73132-5101

Phone

(405) 227-0054

NPI assigned

Jun 27, 2017

Last updated

Mar 12, 2019By 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

Kolton F Erickson, DMD MSD

Title

President

Phone

(405) 227-0054

Specialties & licenses 1

Addresses

Other names 1

• Braces U Oklahoma PLLC Former legal business name

Locations

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552348800000",
    "number": "1851811293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5940 NW EXPRESSWAY # 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731325101",
            "telephone_number": "405-227-0054",
            "fax_number": "970-226-8669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5940 NW EXPRESSWAY # 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731325101",
            "telephone_number": "405-227-0054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Garth Brooks Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Yukon",
            "state": "OK",
            "postal_code": "730997412",
            "country_code": "US",
            "telephone_number": "405-227-0054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RED DIRT ORTHODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2019-03-12",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "KOLTON",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-227-0054",
        "authorized_official_credential": "DMD MSD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Braces U Oklahoma PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Dental Clinic/Center in Oklahoma City, OK
• Providers in Oklahoma City, 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 Mar 12, 2019; 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.