NPIMap

Organization Active NPI

Idental PLLC

  • Dentist
  • Oklahoma City, OK
National Provider Identifier
1932552080
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6138 Issued in OK
Legal business name
IDENTAL PLLC
Practice address
1700 S Sunnylane Rd
Oklahoma City, OK 73115-3118
Phone
(405) 670-5000
Fax
(405) 670-5001
NPI assigned
Jul 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Authorized official

Name
Dr. Toby Rhodes, DDSNPI 1619106457
Title
Dentist
Phone
(405) 830-7988

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6138 OK Primary

Addresses

Primary practice location

1700 S Sunnylane Rd
Oklahoma City, OK 73115-3118

Mailing address

1700 S Sunnylane Rd
Oklahoma City, OK 73115-3118
Phone (405) 670-5000

Other identifiers 1

IdentifierTypeStateIssuer
200252070AMedicaidOK

National Provider Directory

National Provider Directory

Locations

1700 S Sunnylane Rd
Oklahoma City, OK 73115
Phone (405) 670-5000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468368000000",
    "number": "1932552080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 S SUNNYLANE RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731153118",
            "telephone_number": "405-670-5000",
            "fax_number": "405-670-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S SUNNYLANE RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731153118",
            "telephone_number": "405-670-5000",
            "fax_number": "405-670-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-13",
        "last_updated": "2016-07-13",
        "status": "A",
        "authorized_official_last_name": "RHODES",
        "authorized_official_first_name": "TOBY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "405-830-7988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "6138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200252070A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.