EAGLE CREEK FAMILY DENTISTRY PLLC (NPI# 1306331194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306331194 |
| Entity Type | Organization |
| Organization Name | EAGLE CREEK FAMILY DENTISTRY PLLC |
| Practice Address |
4320 Mcauley Blvd Oklahoma City OK 73120-8386 |
| Mailing Address |
775 W Covell Rd Ste 160 Edmond OK 73003-2302 |
| Practice Telephone | 4056225612 |
| Mailing Telephone | 4058446333 |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2018-06-25 |
| Authorized Official Name | TONI WHITE (INSURANCE COORDINATOR) |
| Authorized Official Telephone | 4058446333 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
4320 MCAULEY BLVD |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73120-8386 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164410551 | Brent Warren Moody | Dentist | 4320 Mcauley Blvd, Oklahoma City, OK 73120-8364 | 2005-10-10 |
| 1104336494 | Jennifer Lynne Walker | Dentist | 4320 Mcauley Blvd, Oklahoma City, OK 73120-8386 | 2017-10-02 |
| 1831473743 | Dynamic Dentisty, Pllc | Dentist | 4320 Mcauley Blvd, Oklahoma City, OK 73120-8386 | 2011-10-11 |
| 1720375223 | Jeremy Clark Goodson | Dentist | 4320 Mcauley Blvd, Oklahoma City, OK 73120 | 2011-07-05 |
| 1235375148 | Vernon Matthew Heim | Dentist | 4320 Mcauley Blvd, Oklahoma City, OK 73120-8386 | 2008-12-23 |
| 1225202138 | Brent W. Moody D.d.s., PC | Dentist | 4320 Mcauley Blvd, Oklahoma City, OK 73120-8386 | 2008-04-22 |
| 1255516035 | Robert B. Bryan II, Dds, Pllc | Dentist | 4320 Mcauley Blvd, Oklahoma City, OK 73120-8386 | 2007-12-29 |
| 1851466379 | Robert Bruce Bryan II | Dentist | 4320 Mcauley Blvd, Oklahoma City, OK 73120-8364 | 2006-11-21 |
| 1811094824 | Neil Morgan Glass | Dentist | 4320 Mcauley Blvd, Oklahoma City, OK 73120-8364 | 2006-09-20 |
| 1922040237 | Daniel Steven Scheer | Dentist | 4320 Mcauley Blvd, Oklahoma City, OK 73120-8364 | 2006-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768971 | Nuvail Medical Services Inc | In Home Supportive Care | 3140 West Britton Road, Suite A, Oklahoma City, OK 73120 | 2019-12-26 |
| 1134781677 | Peak Solutions, LLC | Clinic/Center | 12401 Trail Oaks Drive, Therapy Room, 2nd Floor, Oklahoma City, OK 73120 | 2019-07-05 |
| 1992363881 | Laura Lynn's Home Care, LLC | Home Health | 9801 N May Ave, Oklahoma City, OK 73120 | 2019-06-05 |
| 1962992115 | Erin Lyn Florer | Occupational Therapist | 12401 Trail Oak Dr, Oklahoma City, OK 73120 | 2018-05-14 |
| 1780171009 | Diabetic Foot and Wound Center of Okfas | Podiatrist | 11100 Hefner Pointe Drive, Suite A, Oklahoma City, OK 73120 | 2018-04-23 |
| 1285134387 | Motley Vision Professionals, Pllc | Eyewear Supplier (Equipment, not the service) | 9805 N. May Avenue, Oklahoma City, OK 73120 | 2018-02-15 |
| 1043729700 | Jenna Marie Howard | Social Worker | 3301 North Meridian Ave., Building 100, Oklahoma City, OK 73120 | 2017-09-26 |
| 1962928895 | Susan Chacko | Counselor | 12000 N Virginia Avenue, Oklahoma City, OK 73120 | 2017-08-22 |
| 1023533262 | Farris Ree Stroupe | Audiologist | 4140 W. Memorial Rd Suite 116, Oklahoma City, OK 73120 | 2017-08-09 |
| 1881116200 | Rebekah Danielle Kabariti | Counselor | 12000 N. Virgnia Ave, Oklahoma City, OK 73120 | 2017-07-07 |
| Find all providers in zip 73120 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063041275 | Fleming Dental Co Pllc | Clinic/Center | 13316 S Western Ave Ste B, Oklahoma City, OK 73170-7309 | 2020-04-08 |
| 1578103743 | Dental Surgery Center of Midwest City | Clinic/Center | 9060 Harmony Dr Ste E, Oklahoma City, OK 73130-6253 | 2020-01-15 |
| 1053959247 | Phillip J Elassal Dds Pllc | Clinic/Center | 1601 Sw 89th Street #g500, Oklahoma City, OK 73159 | 2019-12-18 |
| 1558902874 | Insight Dental and Implants | Clinic/Center | 3906 Nw 10th St Ste B, Oklahoma City, OK 73107-6060 | 2019-10-08 |
| 1225683311 | I240 Dental | Clinic/Center | 1506 W I 240 Service Rd, Oklahoma City, OK 73159-4126 | 2019-08-06 |
| 1861058877 | Dental Depot of 63rd & Nw Expressway, Pllc | Clinic/Center | 4025 Nw 63rd Street, Oklahoma City, OK 73116 | 2019-05-15 |
| 1285100339 | Moore Dentistry & Braces | Clinic/Center | 1530 Sw 119th St Unit 108, Oklahoma City, OK 73170-4938 | 2018-10-16 |
| 1295254068 | Sih Oklahoma PC | Clinic/Center | 1325 N Walker Ave 547, Oklahoma City, OK 73103-6405 | 2017-09-13 |
| 1851811293 | Red Dirt Orthodontics Pllc | Clinic/Center | 5940 Nw Expressway # 100, Oklahoma City, OK 73132-5101 | 2017-06-27 |
| 1518494384 | Uptown Smiles Pllc | Clinic/Center | 601 Nw 23rd St, Suite 200, Oklahoma City, OK 73103-1415 | 2017-05-11 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73120 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.