Andrea Matli Scoville DDS PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

4530 Issued in OK

Legal business name

ANDREA MATLI SCOVILLE DDS PC

Practice address

601 W 2ND St
Watonga, OK 73772-2601

Phone

(580) 623-7121

Fax

(580) 623-7124

NPI assigned

Feb 24, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Andrea Matli Scoville, DDS

Title

Owner

Phone

(580) 623-7121

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1298505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472428800000",
    "number": "1881991032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W 2ND ST",
            "city": "WATONGA",
            "state": "OK",
            "postal_code": "737722601",
            "telephone_number": "580-623-7121",
            "fax_number": "580-623-7124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 2ND ST",
            "city": "WATONGA",
            "state": "OK",
            "postal_code": "737722601",
            "telephone_number": "580-623-7121",
            "fax_number": "580-623-7124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREA MATLI SCOVILLE DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-24",
        "last_updated": "2016-08-29",
        "status": "A",
        "authorized_official_last_name": "SCOVILLE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "MATLI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-623-7121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OK",
            "license": "4530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ginger Anderson, APRN CNP
• Susan Apple
• Brianna Auge, LPC
• Crystal Axelson
• B.L. Carpenter, M.D. Clinic, PLLC
• Flauryse M Baguidy, DMD

• Orthodontics and Dentofacial Orthopedics Dentistry in Watonga, OK
• Providers in Watonga, OK by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.