NPIMap

Organization Active NPI

Taldg PLLC

Doing business as Ft. Gibson Family Dentistry

  • General Practice Dentistry
  • Fort Gibson, OK
National Provider Identifier
1912668070
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TALDG PLLC
Doing business as
Ft. Gibson Family Dentistry
Practice address
801 S Lee St Ste a
Fort Gibson, OK 74434-8710
Phone
(918) 478-4433
NPI assigned
Dec 31, 2021
Last updated
Jan 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Authorized official

Name
Brandi Williams
Title
VP of Growth
Phone
(405) 250-2255

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary
Dental Clinic/Center 261QD0000X NU

Addresses

Primary practice location

801 S Lee St Ste a
Fort Gibson, OK 74434-8710

Mailing address

801 S Lee St Ste a
Fort Gibson, OK 74434-8710
Phone (918) 478-4433

Other names 1

  • Ft. Gibson Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

801 S Lee St
#A
Fort Gibson, OK 74434
Phone (918) 478-4433

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1640908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1912668070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S LEE ST STE A",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "744348710",
            "telephone_number": "918-478-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S LEE ST STE A",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "744348710",
            "telephone_number": "918-478-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALDG PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-31",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "VP OF GROWTH",
        "authorized_official_telephone_number": "405-250-2255"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ft. Gibson Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ft. Gibson Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Gibson, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.