PEDIATRIC DENTAL GROUP II, LLC (NPI# 1760864235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760864235 |
Entity Type | Organization |
Organization Name | PEDIATRIC DENTAL GROUP II, LLC |
Other Organization Name | PEDIATRIC DENTAL GROUP II, LLC |
Practice Address |
7715 E 91st St Ste A Tulsa OK 74133-6060 |
Mailing Address |
2221 E Bijou St Ste 100 Colorado Springs CO 80909-8009 |
Practice Telephone | 9185853744 |
Mailing Telephone | 7195761850 |
Mailing Fax Number | 7199553470 |
Enumeration Date | 2015-06-22 |
Last Update Date | 2020-03-30 |
Authorized Official Name | SHAUN URBANOZO (CREDENTIALING MANAGER) |
Authorized Official Telephone | 7193232362 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
32 | OK | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OK | OK DENTAL LICENSE | 3942 | 01 |
Other Name | Type Code |
---|---|
Pediatric Dental Group II, LLC | Doing Business As Name - Organization |
Pediatric Dental Group, LLC | Doing Business As Name - Organization |
Address | Telephone Number | Fax Number |
---|---|---|
1200 S Air Depot Blvd, Midwest City, OK 731104866 | 9185853744 | 9185853774 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912553215 | Pediatric Dental Group II, LLC | Clinic/Center | 1200 S Air Depot Blvd, Midwest City, OK 73110-4866 | 2019-08-13 |
Street Address |
7715 E 91ST ST STE A |
City | TULSA |
State | OK |
Zip Code | 74133-6060 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053875690 | Hero Dental of Oklahoma PC | Dentist | 7715 E 91st St Ste A, Tulsa, OK 74133-6060 | 2019-01-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932725058 | Economy Pharmacy | Pharmacy | 10120 E 91st, Tulsa, OK 74133 | 2020-06-24 |
1710539424 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 9310 East 91st Street, Tulsa, OK 74133 | 2019-07-12 |
1003382060 | Carefirst Pharmacy Tulsa, Inc. | Pharmacy | 6214 S. Sheridan Rd, Tulsa, OK 74133 | 2018-10-17 |
1003397332 | Adekemi Taiwo | Nurse Practitioner | Hillcrest South Medical Plaza, 8803 S. 101 St E. Ave. Suite 350, Tulsa, OK 74133 | 2018-08-24 |
1346732013 | Lauren Nichols | Dentist | 7707 E 111th St Ste 105, Tulsa, OK 74133 | 2018-05-30 |
1699264259 | Courtney N Johnson, Pllc | Dentist | 7901 S Sheridan Rd Unit A, Tulsa, OK 74133 | 2018-05-08 |
1417464199 | Tulsa Medical and Orthopedic Center PC | Family Medicine | 8165 S Mingo Rd Ste 200, Tulsa, OK 74133 | 2018-01-04 |
1013421023 | Susan C. Willard, Do, Pllc | Family Medicine | 6532 E. 71st Street, Suite 150, Tulsa, OK 74133 | 2017-11-29 |
1851800825 | Seyva LLC | Clinic/Center | 8522 S 70th E Ave, Tulsa, OK 74133 | 2017-09-21 |
1477072031 | Amanda Dawn Long | Registered Nurse | 10507 E 91st St Ste 310, Tulsa, OK 74133 | 2017-09-14 |
Find all providers in zip 74133 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548472137 | James F. Owens Dds Ms PC | Dentist | 10507 E 91st Street Suite 410, Tulsa, OK 74133 | 2007-05-04 |
1235283524 | Thomas Harold Gilbert Sr. | Dentist | 7116 S Mingo Rd, # 112, Tulsa, OK 74133 | 2007-01-23 |
1932269933 | Charles R. Keithline | Dentist | 1421 E 13th St, Tulsa, OK 74120-5207 | 2006-12-11 |
1356351662 | Mlk Dentistry Inc | Dentist | 2930 S Pittsburg Ave, Tulsa, OK 74114 | 2006-08-09 |
1750326690 | Sarah M Fox | Dentist | 6585 S Yale Ave Ste 510, Tulsa, OK 74136-8384 | 2006-06-17 |
1598742751 | James George Steyer Jr. | Dentist | 10127 S Yale Ave, Tulsa, OK 74137-6002 | 2005-12-29 |
1881688513 | Gary Wallace Fisher | Dentist | 1203 E 33rd St, Ste 100, Tulsa, OK 74105-2040 | 2005-09-08 |
1376542928 | Ronald Lynn Winder | Dentist | 5602 S Memorial Dr, Tulsa, OK 74145-9016 | 2005-07-17 |
1992368278 | On The Cusp Midtown Pllc | Dentist | 4444 S Harvard Ave, Tulsa, OK 74135-2634 | 2019-04-22 |
1114249190 | Fox Broermann Pediatric Dentistry of Tulsa | Dentist | 6585 S Yale Ave Ste 510, Tulsa, OK 74136-8384 | 2010-02-18 |
Find all providers in TULSA |
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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.