NPIMap

Organization Active NPI

Dungarvin Oklahoma LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Oklahoma City, OK
National Provider Identifier
1992870679
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
100631340H Issued in OK
Legal business name
DUNGARVIN OKLAHOMA LLC
Practice address
9210 S Western Ave Ste a-22
Oklahoma City, OK 73139-4982
Phone
(405) 759-2611
Fax
(405) 759-2650
NPI assigned
Nov 21, 2006
Organization subpart
Yes
Parent organization
DUNGARVIN GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Authorized official

Name
Lori Kress
Title
Ceo
Phone
(651) 699-0206

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 100631340H OK Primary

Addresses

Primary practice location

9210 S Western Ave Ste a-22
Oklahoma City, OK 73139-4982

Mailing address

1444 Northland Dr Ste 200
Mendota Heights, MN 55120-1032
Phone (651) 699-0206

Other identifiers 1

IdentifierTypeStateIssuer
100631340HOtherOKOHCA PROVIDER ID

National Provider Directory

National Provider Directory
Tax ID family
Dungarvin Colorado LLC - Colorado Springs4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1992870679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 NORTHLAND DR STE 200",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201032",
            "telephone_number": "651-699-0206",
            "fax_number": "651-699-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9210 S WESTERN AVE STE A-22",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731394982",
            "telephone_number": "405-759-2611",
            "fax_number": "405-759-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNGARVIN OKLAHOMA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DUNGARVIN GROUP, INC.",
        "enumeration_date": "2006-11-21",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "KRESS",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-699-0206"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OK",
            "license": "100631340H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHCA PROVIDER ID",
            "identifier": "100631340H",
            "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 Apr 27, 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.