IMPRESSIONS DENTAL


Address: 2510 E Independence St Ste 600, Shawnee, OK 74804-1839
Phone: 4052732002

IMPRESSIONS DENTAL (NPI# 1144494147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223G0001X Dentist
Specialization: General Practice
5285 OK Dental Providers

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1033398870 Impressions Dental Dentist 5970 S Cooper Rd, Ste 1, Chandler, AZ 85249-5393 2007-10-29

Other Data Sources

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

Office Location

Street Address 2510 E INDEPENDENCE ST STE 600
City SHAWNEE
State OK
Zip Code 74804-1839

Providers in the same location

NPI Name Taxonomy Address Enumeration
1013322312 Nicklaus Clifford Dentist 2510 E Independence St Ste 600, Shawnee, OK 74804-1839 2014-06-25

Providers in the same zip code

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 Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

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

Providers in the same taxonomy and city

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

Competitor

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City SHAWNEE
Zip Code 74804

Improve Information

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Dataset Information

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.

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