DENTAL GROUP PC (NPI# 1043480924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043480924 |
| Entity Type | Organization |
| Organization Name | DENTAL GROUP PC |
| Practice Address |
109 N Fairland St Ste 110 Pryor OK 74361-4203 |
| Mailing Address |
Po Box 649 Pryor OK 74362-0649 |
| Practice Telephone | 9188257411 |
| Practice Fax Number | 9188257734 |
| Mailing Telephone | 9188257411 |
| Mailing Fax Number | 9188257734 |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-03-06 |
| Authorized Official Name | FREDA JANE ANDERSON (OFFICE MANAGER) |
| Authorized Official Telephone | 9188257411 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
4382 | OK | Dental Providers |
| Street Address |
109 N FAIRLAND ST STE 110 |
| City | PRYOR |
| State | OK |
| Zip Code | 74361-4203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942286133 | Jan Ellen Wells | Nurse Practitioner | 109 N Fairland St, Suite 104, Pryor, OK 74361-4203 | 2005-12-19 |
| 1740893296 | Erin Dinsmore | Peer Specialist | 109 N Fairland St, Pryor, OK 74361-4205 | 2020-08-25 |
| 1609489228 | Wendy Dotson | Peer Specialist | 109 N Fairland St, Pryor, OK 74361-4203 | 2020-08-24 |
| 1063022077 | Daylon Cheyenne Ramsey | Peer Specialist | 109 N Fairland St, Pryor, OK 74361-4205 | 2020-08-04 |
| 1548885502 | Riley Danielle Pope | Counselor | 109 N Fairland St, Pryor, OK 74361-4205 | 2020-06-15 |
| 1013532076 | Breanna Nicole Cook | Counselor | 109 N Fairland St, Pryor, OK 74361-4205 | 2020-06-15 |
| 1285254490 | Briana Renee Andrews | Peer Specialist | 109 N Fairland St, Pryor, OK 74361-4203 | 2020-04-17 |
| 1215556410 | Carly Ann Disalvatore | Case Manager/Care Coordinator | 109 N Fairland St, Pryor, OK 74361-4203 | 2020-04-09 |
| 1568081677 | Zack Ellard | Peer Specialist | 109 N Fairland St, Pryor, OK 74361-4203 | 2020-04-09 |
| 1518593011 | Klarissa Autumn Hall | Occupational Therapy Assistant | 109 N Fairland St, Pryor, OK 74361-4203 | 2020-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740787928 | Ahs Pryor Hospital, LLC | Clinic/Center | 1301 Ne 1st St Ste 400, Pryor, OK 74361 | 2018-04-12 |
| 1073029310 | Amber Bowman | Registered Nurse | 109 N. Fairland, Pryor, OK 74361 | 2017-12-22 |
| 1922361096 | Crystal Noel Parrett | Counselor | 215 N. Fairland, Pryor, OK 74361 | 2012-06-22 |
| 1447516703 | Rocky Mountain Holdings LLC | Ambulance | 591 Airport Rd, Pryor, OK 74361 | 2012-04-11 |
| 1356673180 | Tressa Fern Rice | Speech-Language Pathologist | 510 S. Elliott St. Suite C, Mayes County Speech Therapy, Pryor, OK 74361 | 2010-02-04 |
| 1083945208 | Ladena Carol Moore | Counselor | 212 S E 1st, Pryor, OK 74361 | 2010-01-28 |
| 1164753323 | Anita K Sanders | Counselor | 212 Se 1st, Pryor, OK 74361 | 2010-01-27 |
| 1619203775 | Sandra Kay Runnells | Psychologist | 109 South Fairland, Suite 101, Pryor, OK 74361 | 2009-10-26 |
| 1972838969 | Ramona L Whitehurst | Advanced Practice Midwife | 1400 Willow Road, Pryor, OK 74361 | 2009-10-08 |
| 1396971297 | Shauna Leann Jackson | Speech-Language Pathologist | 510 S. Elliott, Suite C, Pryor, OK 74361 | 2009-06-05 |
| Find all providers in zip 74361 | ||||
| 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 |
|---|---|---|---|---|
| 1922573500 | Advanced Dental Solutions, PC | Dentist | 1909 S Elliott St, Pryor, OK 74361-8027 | 2018-10-10 |
| 1174807929 | Lori Triebel Smith | Dentist | 13 S Coo Y Yah St, Pryor, OK 74361-4624 | 2011-09-28 |
| 1588957567 | Peak Dental Group LLC | Dentist | 4 N Coo Y Yah St, Pryor, OK 74361-3820 | 2011-05-24 |
| 1073764205 | Stephen Taylor Foreman | Dentist | 4 N. Coo-y-yah, Pryor, OK 74361 | 2008-10-07 |
| 1952400079 | Mark Robert Doherty | Dentist | 26 Surfside Rd, Pryor, OK 74361-3306 | 2006-09-22 |
| 1205935368 | Lori Smith Dds Inc PC | Dentist | 13 South Cooyyah, Pryor, OK 74361 | 2006-09-22 |
| 1902911951 | David George Hoffman | Dentist | 101 S Adair St, Pryor, OK 74361 | 2006-08-20 |
| 1184647653 | Rhett Brandon Rains | Dentist | 6 S. Rowe, Pryor, OK 74361 | 2006-07-25 |
| 1013438100 | Bryce E Slack | Dentist | 101 S Adair St, Pryor, OK 74361-3625 | 2017-06-29 |
| 1801333067 | Spring Dental Pryor | Dentist | 101 S Adair St, Pryor, OK 74361-3625 | 2017-01-26 |
| Find all providers in PRYOR | ||||
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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.