Janna Lynn Pettigrew, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

6034 Issued in OK

Practice address

925 W Broadway Ave
Sulphur, OK 73086-4409

Phone

(580) 622-6144

Fax

(580) 622-5350

NPI assigned

Jun 23, 2008

Last updated

Jul 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arbuckle Dental PLLC

  • General Practice Dentistry
  • Sulphur, OK
  • NPI 1457593170
  NPD (past)
• Elbert a. Franklin, D.D.S.

  • General Practice Dentistry
  • Sulphur, OK
  • NPI 1073769634
  NPD (past)

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1982865812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 W BROADWAY AVE",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730864409",
            "telephone_number": "580-622-6144",
            "fax_number": "580-622-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 W BROADWAY AVE",
            "city": "SULPHUR",
            "state": "OK",
            "postal_code": "730864409",
            "telephone_number": "580-622-6144",
            "fax_number": "580-622-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "JANNA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6034",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3728",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200212860A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan William Oden, D.O.
• Jonathan Ohenhen, MD
• Oklahoma School for the Deaf
• Marjorie Parker
• Renee Patrick
• David R Pittman, RPH
• Brittany Nikita Skye Portwood
• Aaron Ruben Puga
• Bill W. Rains, D.C.
• Misty Marie Raymo

• Dentist in Sulphur, OK
• Providers in Sulphur, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.