Oragen Lawton Oral Surgery PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ORAGEN LAWTON ORAL SURGERY PC

Doing business as

Lawton Oral Surgery

Practice address

3617 W Gore Blvd
Lawton, OK 73505-6373

Phone

(405) 691-0155

NPI assigned

Aug 17, 2023

Last updated

Aug 17, 2023By 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

Whitney Pavick

Title

Sr. Operations Manager

Phone

(801) 857-7947

Specialties & licenses 1

Addresses

Other names 1

• Lawton Oral Surgery Doing business as

Locations

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1912780560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3617 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056373",
            "telephone_number": "405-691-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAGEN LAWTON ORAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "PAVICK",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_title_or_position": "SR. OPERATIONS MANAGER",
        "authorized_official_telephone_number": "801-857-7947"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lawton Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanner Wayne Olsen, PHARMD
• Joann Omengebar, LMT
• Rhodora Ong, PT
• Ashley Ontiveros
• Open Arms Behavioral Health, LLC
• Hunter Ortega, H.I.S
• Travis G Ortega, AUD.
• Ty Ortega, H.I.S
• Jesslyan Marie Ortiz-Albino, RBT
• Alicia Ortiz, DNP, NP-C

• Oral and Maxillofacial Surgery (Dentist) in Lawton, OK
• Providers in Lawton, OK by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.