IMPRESSIONS DENTAL (NPI# 1144494147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144494147 |
Entity Type | Organization |
Organization Name | IMPRESSIONS DENTAL |
Practice Address |
2510 E Independence St Ste 600 Shawnee OK 74804-1839 |
Practice Telephone | 4052732002 |
Mailing Telephone | 4052732002 |
Enumeration Date | 2008-04-22 |
Last Update Date | 2008-04-22 |
Authorized Official Name | DR. RENALLA KAYE ELLIS (OWNER) |
Authorized Official Telephone | 4052732002 |
Authorized Official Credential | D.D.S. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
5285 | OK | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033398870 | Impressions Dental | Dentist | 5970 S Cooper Rd, Ste 1, Chandler, AZ 85249-5393 | 2007-10-29 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Indiana Business Entities | IMPRESSIONS DENTAL LABORATORY, INC. | C/o Robert D. Clarke, 8168 W. Fairfield Dr, Waynetown, IN 47990 |
Colorado Business Entities | Impressions Dental Spa, LLC | 191 University Blvd, 522, Denver, CO 80206 |
Street Address |
2510 E INDEPENDENCE ST STE 600 |
City | SHAWNEE |
State | OK |
Zip Code | 74804-1839 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013322312 | Nicklaus Clifford | Dentist | 2510 E Independence St Ste 600, Shawnee, OK 74804-1839 | 2014-06-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164063699 | Isaac Benjamin Gray | Student in an Organized Health Care Education/Training Program | 4010 Blaine Road, Shawnee, OK 74804 | 2019-10-06 |
1750863775 | Dillon Gibson | Specialist/Technologist | Oklahoma Baptist University, 500 W. University, Shawnee, OK 74804 | 2018-09-06 |
1912368242 | Peggy Baker | Occupational Therapist | 7602 N. Kickapoo, Shawnee, OK 74804 | 2016-03-15 |
1861731093 | Shariff Mohammed El-assi | Behavioral Analyst | 45 Crown Point, Shawnee, OK 74804 | 2013-02-07 |
1902103112 | Action Physical Therapy & Rehabilitation, Pllc | Physical Therapist | 2506 N Harrison, Shawnee, OK 74804 | 2011-02-24 |
1639493315 | Oklahoma Em - 1 Medical Services,p.c. | Emergency Medicine | 1102 W.macarthur, Shawnee, OK 74804 | 2010-03-24 |
1790989473 | Eastern Oklahoma Radiation Associates, LLC | Radiology | 3700 N Kickapoo Ave Ste 108, Shawnee, OK 74804 | 2007-06-14 |
1821210444 | Mickey Sehorn D.d.s., P.C. | Dentist | 1601 Airport Drive, Shawnee, OK 74804 | 2007-05-03 |
1760525711 | Leanna Rae Olsen | Registered Nurse | 1500 N. Kickapoo, Suite #4, Shawnee, OK 74804 | 2007-02-15 |
1467517920 | Mahmoud Abdel-fattah Khalifa | Pathology | Unity Health Center, 1102 West Macarthur, Shawnee, OK 74804 | 2006-12-26 |
Find all providers in zip 74804 |
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 |
---|---|---|---|---|
1326656117 | Joel David Piper | Dentist | 10840 Shawnee Mission Pkwy, Shawnee, KS 66203-3512 | 2020-07-17 |
1518450642 | Matthew Nicholas Scott | Dentist | 6852 Silverheel St, Shawnee, KS 66226-5300 | 2018-06-13 |
1710498050 | Reggie Cooley | Dentist | 4520 Market Place Blvd, Shawnee, OK 74804-0804 | 2017-10-13 |
1184834145 | Andrew Stewart Moore | Dentist | 5550 Hedge Lane Ter, Shawnee, KS 66226-2253 | 2007-05-22 |
1205959582 | Charles B Swain | Dentist | 5638 Nieman Rd, Shawnee, KS 66203-2348 | 2007-04-09 |
1912026162 | Amy Laymon | Dentist | 4520 Market Place Blvd Ste A, Shawnee, OK 74804-0805 | 2007-03-28 |
1295854958 | Jack C Luman | Dentist | 1410 N Harrison St, Shawnee, OK 74801 | 2007-03-27 |
1659412237 | Carol J. Akers | Dentist | 12480 W 62nd Ter Ste 200, Shawnee, KS 66216 | 2007-02-08 |
1720128002 | Ocean Dental, PC | Dentist | 4409 N Kickapoo Ave, Shawnee, OK 74804-1206 | 2007-02-07 |
1639220148 | Catherine T. Uypeckcuat | Dentist | 22740 Midland Dr, Shawnee, KS 66226-3553 | 2007-01-13 |
Find all providers in SHAWNEE |
Please comment or provide details below to improve the information on IMPRESSIONS DENTAL.
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.