LAKE COUNTRY ORTHODONTICS (NPI# 1962013813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962013813 |
| Entity Type | Organization |
| Organization Name | LAKE COUNTRY ORTHODONTICS |
| Practice Address |
1119 Walnut Dr Ste 4 Ardmore OK 73401-2360 |
| Practice Telephone | 5802262331 |
| Practice Fax Number | 5802268776 |
| Mailing Telephone | 5802262331 |
| Mailing Fax Number | 5802268776 |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-13 |
| Authorized Official Name | MRS. LORI A MILLER (OFFICE MANAGER) |
| Authorized Official Telephone | 5802262331 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Stretesky Orthodontics | Doing Business As Name - Organization |
| Street Address |
1119 WALNUT DR STE 4 |
| City | ARDMORE |
| State | OK |
| Zip Code | 73401-2360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497391452 | Abbie Deeann Mclemore | Nurse Practitioner | 915 10th Ave, Ardmore, OK 73401 | 2019-11-25 |
| 1790349991 | Shirley Denise Brown | Licensed Psychiatric Technician | 1219 Kst N.w, 1219 Kst N.w, Ardmore, OK 73401 | 2019-04-24 |
| 1427512359 | Billy Joe Oshields | Case Manager/Care Coordinator | 6862 State Hwy 199 Ardmore Oklahoma, 6862 State Hwy 199, Ardmore, OK 73401 | 2019-01-24 |
| 1174007595 | Tawnya Dawn Peery | Nurse Practitioner | 1108 W. Walnut Drive, Ardmore, OK 73401 | 2018-09-21 |
| 1679055016 | Teresa Marie Hernandez | Behavior Technician | 1219 K St. Nw, Ardmore, OK 73401 | 2018-09-01 |
| 1063991974 | Sawyer Rae Shamburger | Occupational Therapy Assistant | 208 North Praire St, Pilot Point, TX 73401 | 2018-08-10 |
| 1417473521 | Chelsye Bacon | Peer Specialist | 905 Holiday Drive, Ardmore, OK 73401 | 2017-08-21 |
| 1003279746 | Jeni Presley | Marriage & Family Therapist | Outpatient Services-ardmore; 2510 Chickasaw Dr., Strong Family Development;, Ardmore, OK 73401 | 2016-03-31 |
| 1982080909 | Alison Hill | Pharmacist | 1111 N. Commerce, Ardmore, OK 73401 | 2015-07-31 |
| 1316346547 | Olivia Larae Carrell | Counselor | 15 Monroe Street Ne, Ardmore, OK 73401 | 2014-08-13 |
| Find all providers in zip 73401 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457595266 | Gerken Orthodontics, LLC | Dentist | 1201 Kiowa St, Ardmore, OK 73401-2260 | 2009-04-23 |
| 1174680896 | Tony Stretesky Dds | Dentist | 1119 Walnut Drive, Suite 4, Ardmore, OK 73401 | 2007-01-02 |
| 1063585073 | Craig A Gerken | Dentist | 1201 Kiowa Street, Ardmore, OK 73401-2246 | 2006-11-16 |
| 1932556925 | Ardmore Pediatric Dental Associates PC | Dentist | 233 E Lancaster Ave, Suite 201, Ardmore, PA 19003-2321 | 2016-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285284919 | Marlo A. Miller Dds, Ms | Dentist | 816 S Mustang Rd, Yukon, OK 73099-6767 | 2019-09-15 |
| 1215480371 | Gabriel Luttrell | Dentist | 421 Nw 10th St, Suite 201-e, Oklahoma City, OK 73103-3909 | 2016-07-25 |
| 1417328170 | Tyler Holt | Dentist | 157 Stonebridge Blvd Apt 2223, Edmond, OK 73013-4773 | 2015-10-07 |
| 1235525734 | Christopher Trockel Orthodontics PC | Dentist | 12345 S Memorial Dr Ste 113, Bixby, OK 74008-2571 | 2015-04-10 |
| 1275921769 | Orthodontic Specialists of Shawnee | Dentist | 18 E Dunloup Rd, Shawnee, OK 74804-3203 | 2015-01-06 |
| 1629474127 | Smile Galaxy Orthodontics | Dentist | 10001 S Pennsylvania Ave Bldg P, Suite #130, Oklahoma City, OK 73159-6923 | 2014-11-10 |
| 1831505999 | Gabriela Restuccia | Dentist | 1201 N Stonewall Ave Rm 449, Oklahoma City, OK 73117-1214 | 2014-07-09 |
| 1962818351 | Dental Depot Orthodontics Sw Okc, Pllc | Dentist | 6217 S Western Ave Ste A, Oklahoma City, OK 73139-1605 | 2014-07-07 |
| 1730502519 | Dental Depot Orthodontics North Okc Pllc | Dentist | 14440 N Penn Ave, Oklahoma City, OK 73134-6003 | 2014-01-29 |
| 1295168284 | Craig & Streight Orthodontics | Dentist | 706 24th Ave Nw, Norman, OK 73069-6232 | 2013-08-14 |
| Find all providers with the same taxonomy | ||||
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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.