Active NPI
Joseph Omer Lavalley, D.D.S.
- Dentist
- Holdenville, OK
National Provider Identifier
1861484776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5172
- Practice address
- 300 E Hwy
Holdenville, OK 74848 - Phone
- (405) 379-2700
- Fax
- (405) 379-2703
- NPI assigned
- Aug 17, 2005
- Reactivated
- Mar 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5172 | OK | Primary |
| Dentist | 122300000X | 19688 | TX |
Addresses
Primary practice location
300 E Hwy
Holdenville, OK 74848
Mailing address
300 E Hwy
Holdenville, OK 74848
Phone (405) 379-2700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19688 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lavalley Dental Care, Inc. | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Holdenville, OK
- NPI 1740455674
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1861484776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E HWY",
"city": "HOLDENVILLE",
"state": "OK",
"postal_code": "74848",
"telephone_number": "405-379-2700",
"fax_number": "405-379-2703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E HWY",
"city": "HOLDENVILLE",
"state": "OK",
"postal_code": "74848",
"telephone_number": "405-379-2700",
"fax_number": "405-379-2703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVALLEY",
"first_name": "JOSEPH",
"middle_name": "OMER",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-17",
"last_updated": "2007-07-09",
"deactivation_date": "2006-03-23",
"reactivation_date": "2006-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "5172",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "19688",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holdenville, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.