DENTAL DEPOT ORTHODONTICS SW OKC, PLLC (NPI# 1962818351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962818351 |
| Entity Type | Organization |
| Organization Name | DENTAL DEPOT ORTHODONTICS SW OKC, PLLC |
| Practice Address |
6217 S Western Ave Ste A Oklahoma City OK 73139-1605 |
| Practice Telephone | 4056067123 |
| Practice Fax Number | 4056067130 |
| Mailing Telephone | 4056067123 |
| Mailing Fax Number | 4056067130 |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2014-07-07 |
| Authorized Official Name | GLENN ALLAN ASHMORE (OWNER / PRESIDENT) |
| Authorized Official Telephone | 4059490123 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| Street Address |
6217 S WESTERN AVE STE A |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73139-1605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447899778 | First Med Primary Care LLC | Clinic/Center | 1142 Sw 104th St, Oklahoma City, OK 73139 | 2020-01-03 |
| 1205305737 | Transit Medical Team LLC | In Home Supportive Care | 1145 S I-240 Service Rd Ste F, Oklahoma City, OK 73139 | 2018-11-14 |
| 1336621770 | Mayra Edith Solis | Case Manager/Care Coordinator | 6510 S. Western Ave Bldg. 400, Oklahoma City, OK 73139 | 2018-09-01 |
| 1619470184 | Linzi L Stewart, D.o., P.l.l.c. | Obstetrics & Gynecology | 10400 S Western Ave Ste 7, Oklahoma City, OK 73139 | 2018-03-12 |
| 1467970467 | Oklahoma Healthcare Transitions Inc | Home Health | 6803 S Western Ave Ste 400, Oklahoma City, OK 73139 | 2017-08-30 |
| 1841714169 | Gentry Kyler Jones | Case Manager/Care Coordinator | 301 W I240 Service Rd, Oklahoma City, OK 73139 | 2017-07-28 |
| 1437688082 | Jasmine Small | Case Manager/Care Coordinator | 6100 S Walker, Okc, OK 73139 | 2017-06-07 |
| 1689029266 | Swalk Operations, LLC | Skilled Nursing Facility | 315 Sw 80th Street, Oklahoma City, OK 73139 | 2016-05-02 |
| 1225491343 | Elizabeth Pratt | Counselor | 301 Interstate 240 Service Rd, Oklahoma City, OK 73139 | 2016-04-05 |
| 1326418542 | Brittany Elis Walley | Case Manager/Care Coordinator | 8015 S Klein Ave, Oklahoma City, OK 73139 | 2015-09-30 |
| Find all providers in zip 73139 | ||||
| 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 |
|---|---|---|---|---|
| 1215480371 | Gabriel Luttrell | Dentist | 421 Nw 10th St, Suite 201-e, Oklahoma City, OK 73103-3909 | 2016-07-25 |
| 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 |
| 1730502519 | Dental Depot Orthodontics North Okc Pllc | Dentist | 14440 N Penn Ave, Oklahoma City, OK 73134-6003 | 2014-01-29 |
| 1396993051 | Melissa Leann Farrow | Dentist | 8301 S. Walker, Suite 103, Oklahoma City, OK 73139-9449 | 2008-09-05 |
| 1861611535 | Mark L Youngker | Dentist | 4401 W Memorial Rd Ste 113, Oklahoma City, OK 73134-1722 | 2007-04-24 |
| 1538212766 | Ou Graduate Orthodontics | Dentist | 1201 N Stonewall, Room 442, Oklahoma City, OK 73117-1214 | 2007-01-19 |
| 1659437234 | Marlo Anneene Miller | Dentist | 3501 Nw 50th St, Oklahoma City, OK 73112-5603 | 2006-12-28 |
| 1366513699 | Jeffrey Todd Cohlmia | Dentist | 13313 North Meridian, Suite D4, Oklahoma City, OK 73120-8380 | 2006-11-10 |
| 1902909195 | Christian Gerard Zylinski | Dentist | 3727 Nw 63rd, Ste 100, Oklahoma City, OK 73116 | 2006-09-06 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73139 |
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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.