DENTAL BOUTIQUE PLLC (NPI# 1922643543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1922643543 |
Entity Type | Organization |
Organization Name | DENTAL BOUTIQUE PLLC |
Practice Address |
3621 Nw 63rd St Ste C Oklahoma City OK 73116-2041 |
Practice Telephone | 4058488838 |
Mailing Telephone | 4058488838 |
Enumeration Date | 2019-11-07 |
Last Update Date | 2019-11-07 |
Authorized Official Name | KAMELIYA CHERVILOV (OWNER) |
Authorized Official Telephone | 4058488838 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407220429 | Dental Boutique Pllc | Dentist | 9738 Katy Fwy Ste 400, Houston, TX 77055-6214 | 2015-11-16 |
Street Address |
3621 NW 63RD ST STE C |
City | OKLAHOMA CITY |
State | OK |
Zip Code | 73116-2041 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306455068 | Restore Family Counseling, LLC | Clinic/Center | 100 W. Wilshire, Suite #c3, Oklahoma City, OK 73116 | 2020-07-29 |
1861058877 | Dental Depot of 63rd & Nw Expressway, Pllc | Clinic/Center | 4025 Nw 63rd Street, Oklahoma City, OK 73116 | 2019-05-15 |
1073001756 | Oklahoma Clinical Management LLC | Prevention Professional | 4301 Nw 63rd St Ste 107, Oklahoma City, OK 73116 | 2018-04-27 |
1235658261 | Heinen Physical Therapy, PC | Clinic/Center | 7710 N May Ave, Oklahoma City, OK 73116 | 2017-09-11 |
1235657842 | Jacque S Komers | Counselor | 6501 N Broadway Ext Suite 180, Oklahoma City, OK 73116 | 2017-09-04 |
1164943874 | Jo Ann Cole-johnson | Counselor | 6505 N. Shawnee Ave, Oklahoma, OK 73116 | 2017-07-03 |
1548790793 | Zachary Wayne Skates | Case Manager/Care Coordinator | North 6501 Broadway Extention Highway #180, Oklahoma City, OK 73116 | 2017-06-19 |
1548622673 | Jessica Defiore | Case Manager/Care Coordinator | 6501 N Broadway Extension, Oklahoma City, OK 73116 | 2016-03-28 |
1093173247 | Patrice Ann Cook | Specialist/Technologist, Other | 7700 N. Hudson Ave, Suite Number 9, Oklahoma City, OK 73116 | 2016-02-03 |
1467880708 | Abrina Marie Kneeland | Occupational Therapy Assistant | 6525 N. Meridian #311, Therapists Unlimited Division of Career Staff, Oklahoma City, OK 73116 | 2013-10-24 |
Find all providers in zip 73116 |
Taxonomy Code | 1223G0001X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | General Practice |
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
Notes: Source: Academy of General Dentistry |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942808928 | Dentists of Oklahoma City, PC | Dentist | 12200 N Macarthur Blvd Ste I, Oklahoma City, OK 73162-1849 | 2020-10-13 |
1093332959 | Graham Thomas Shadwick | Dentist | 1201 N Stonewall Ave Rm 241, Oklahoma City, OK 73117-1214 | 2020-06-26 |
1255960399 | Graden Trumble | Dentist | 1201 N Stonewall Ave Rm 452, Oklahoma City, OK 73117-1214 | 2020-04-01 |
1790322543 | Easy Dental South Pllc | Dentist | 10001 S Penn Ave Ste 22, Oklahoma City, OK 73159-6923 | 2019-11-27 |
1841846474 | Designs In Dentistry | Dentist | 14810 Serenita Ave, Oklahoma City, OK 73134 | 2019-08-09 |
1447715453 | Roman Michael Garcia | Dentist | Ou Children's Physicians - Dental Clinic, 1200 Children's Ave, 8f, Oklahoma City, OK 73104 | 2019-02-04 |
1326556242 | Steve Huy Truong, Dds, Pllc | Dentist | 16 Ne 2nd St Ste B, Oklahoma City, OK 73104-2210 | 2018-01-12 |
1326576497 | Noel Robert Williams Jr. | Dentist | 1325 N Walker Ave Apt 204, Oklahoma City, OK 73103-6414 | 2017-06-01 |
1790213486 | Ty Allen Mays Jr. | Dentist | 25 N Rockwell Ave, Oklahoma City, OK 73127-6112 | 2017-05-25 |
1811425416 | Ryan Chandler | Dentist | 5653 N Classen Blvd, Oklahoma City, OK 73118-4015 | 2017-05-25 |
Find all providers in OKLAHOMA CITY |
City | OKLAHOMA CITY |
Zip Code | 73116 |
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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.