PEDIATRIC DENTAL PARTNERS PLLC (NPI# 1093062911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093062911 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTAL PARTNERS PLLC |
| Other Organization Name | PEDIATRIC DENTAL OKC |
| Practice Address |
5940 Nw Expressway Ste 200 Oklahoma City OK 73132-5101 |
| Practice Telephone | 4054955600 |
| Practice Fax Number | 4054955602 |
| Mailing Telephone | 4054955600 |
| Mailing Fax Number | 4054955602 |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2018-12-18 |
| Authorized Official Name | ANGIE STECKER (OFFICE MANAGER) |
| Authorized Official Telephone | 4054955600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
89 | OK | Dental Providers |
| Other Name | Type Code |
|---|---|
| Pediatric Dental OKC | Doing Business As Name - Organization |
| Street Address |
5940 NW EXPRESSWAY STE 200 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73132-5101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790348266 | Solid Rock Home Care Assistance LLC | Registered Nurse | 6408 Galaxie Dr., Oklahoma City, OK 73132 | 2019-04-19 |
| 1427525443 | Allison Latham | Counselor | 6812 St. Pl., Oklahoma City, OK 73132 | 2018-10-29 |
| 1811426182 | Larry D. Brown | Counselor | 4717 Nw 70th St., Oklahoma City, OK 73132 | 2017-06-08 |
| 1639600307 | Tram Nguyen | Physician Assistant | 500 Sw44th Street, Oklahoma City, OK 73132 | 2017-03-24 |
| 1386190973 | Moneka Jeffers | Counselor | 8117 Nw 81st St, Oklahoma City, OK 73132 | 2016-09-01 |
| 1861873085 | Express Family Care LLC | Clinic/Center | 7117 W. Wilshire Blvd, Oklahoma City, OK 73132 | 2015-06-12 |
| 1689941809 | Ade A Bajulaiye | Psychologist | 8122 N.w. 78th Ter, Okc, Oklahoma, OK 73132 | 2011-11-17 |
| 1457633281 | Chandell Bell | Counselor | 6908 Woodlake Dr, Okc, OK 73132 | 2011-09-19 |
| 1588944615 | Jason Bennell Rayfield | Social Worker | 7221 Edenborough, Oklahoma City, OK 73132 | 2011-08-20 |
| 1952600785 | Derell Jovan Spires | Counselor | 9242 North Mcarthur Blvd Apt A, Oklahoma City, OK 73132 | 2011-03-18 |
| Find all providers in zip 73132 | ||||
| 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 |
|---|---|---|---|---|
| 1932684297 | Jemima Poitevien, D.d.s., P.l.l.c. | Dentist | 4225 W Memorial Rd Ste 101-b, Oklahoma City, OK 73134-1761 | 2018-10-02 |
| 1508023383 | Thai-an Doan D.d.s. P.C. | Dentist | 11318 N May Ave, Suite B, Oklahoma City, OK 73120-5860 | 2008-05-20 |
| 1619162054 | Robert Brian Molloy | Dentist | 9801 S Pennsylvania Ave, Oklahoma City, OK 73159-6925 | 2007-09-10 |
| 1467574004 | Smiling Faces Pediatric Dentistry Inc | Dentist | 5222 N. Portland, Oklahoma City, OK 73112 | 2007-04-04 |
| 1760521934 | Elizabeth Kellner | Dentist | 828 Sw 66th St, Oklahoma City, OK 73139-4213 | 2007-02-05 |
| 1194828558 | Thai-an Doan | Dentist | 14228 Barbour Ave, Oklahoma City, OK 73134 | 2006-09-07 |
| 1780618330 | Andrew Cleveland Guthrie | Dentist | 3616 Nw 50th St, Oklahoma City, OK 73112-5642 | 2006-07-10 |
| 1558318493 | Donald Wood Haskins | Dentist | 5222 N Portland Ave, Oklahoma City, OR 73112 | 2006-05-27 |
| 1720063225 | William G Bozalis | Dentist | 3613 Nw 56th, Suite 105 Three Corporate Plaza, Oklahoma City, OK 73112 | 2005-12-07 |
| 1164410551 | Brent Warren Moody | Dentist | 4320 Mcauley Blvd, Oklahoma City, OK 73120-8364 | 2005-10-10 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73132 |
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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.