OKLAHOMA ENDODONTICS (NPI# 1174607261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174607261 |
| Entity Type | Organization |
| Organization Name | OKLAHOMA ENDODONTICS |
| Practice Address |
1008 Nw Grand Blvd Suite A Oklahoma City OK 73118 |
| Practice Telephone | 4058439330 |
| Practice Fax Number | 4058484048 |
| Mailing Telephone | 4058439330 |
| Mailing Fax Number | 4058484048 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. DAVID BRIAN SHADID (PARTNER) |
| Authorized Official Telephone | 4058439330 |
| Authorized Official Credential | DDS MSD PC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
512734 | OK | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
458428 | OK | Dental Providers |
| Street Address |
1008 NW GRAND BLVD SUITE A |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730269507 | Kay Arlene Ludwig | Counselor | 1008 Nw Grand Blvd, Suite C, Oklahoma City, OK 73118-6036 | 2006-10-16 |
| 1104084359 | Dennis Allan Leseberg | Dentist | 1008 Nw Grand Blvd, Suite A, Oklahoma City, OK 73118-6084 | 2008-05-23 |
| 1316083363 | Joseph B Couch | Psychologist | 1008 Nw Grand Blvd, Suite C, Oklahoma City, OK 73118 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255812772 | Karrie Danea Moreno | Behavior Technician | 1507 Ne 31st, Oklahoma, OK 73118 | 2018-08-23 |
| 1528578499 | Revive Medical LLC | General Practice | 4215 N Classen Blvd Ste 103, Oklahoma City, OK 73118 | 2017-10-05 |
| 1225556228 | Anika Carr | Case Manager/Care Coordinator | 1212 Nw 32nd Street, Oklahoma City, OK 73118 | 2017-08-30 |
| 1740635168 | Nikhil Malhotra | Internal Medicine | 3635 Vista Avenue At Grand Boulevard, 14th Floor, Desloge Towers, St. Louis, MO 73118 | 2016-05-04 |
| 1144694183 | Christopher Woon | Counselor | 4001 N Classen, Suite 105, Oklahoma City, OK 73118 | 2015-11-13 |
| 1699181925 | Stac Embry | Counselor | 3321 N. Mckinley Ave, Oklahoma City, OK 73118 | 2014-07-08 |
| 1194161216 | Jennifer Kaye Powers | Counselor | 3124 N. Classen Blvd., Ste. A, Oklahoma City, OK 73118 | 2013-05-15 |
| 1932445491 | Jessica Camp | Behavioral Analyst | 3220 N Harvey Pkwy, Oklahoma City, OK 73118 | 2013-01-02 |
| 1942578661 | Michael D Danielson | Behavioral Analyst | 4232 N Sante Fe Ave, Oklahoma City, OK 73118 | 2011-12-08 |
| 1912280587 | Tara Roberts | Counselor | 1743 Nw 37th, Oklahoma City, OK 73118 | 2011-09-21 |
| Find all providers in zip 73118 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629290242 | Kim Loren Wilkinson | Dentist | 13851 Quail Pointe Dr, Oklahoma City, OK 73134-1021 | 2007-05-03 |
| 1437207560 | David J Clement | Dentist | 1201 N Stonewall Ave., Ouhsc College of Dentistry, Oklahoma City, OK 73117 | 2007-01-08 |
| 1982616256 | William Lee Beasley I | Dentist | 4500 Memorial Cir, Oklahoma City, OK 73142-5003 | 2006-08-13 |
| 1952919052 | Endodontic Associates Pllc | Dentist | 4500 Memorial Cir, Oklahoma City, OK 73142-5002 | 2020-07-15 |
| 1275915126 | Suhair Jambi | Dentist | 1201 N Stonewall Ave, Oklahoma City, OK 73117-1214 | 2015-06-26 |
| 1932587375 | University of Oklahoma | Dentist | 1201 N Stonewall Ave, Oklahoma City, OK 73117-1214 | 2015-05-18 |
| 1619307865 | North Pointe Endodontics, Pllc | Dentist | 13851 Quail Pointe Dr, Oklahoma City, OK 73134-1021 | 2013-11-24 |
| 1396901567 | Stephen G Biggs | Dentist | 1201 N Stonewall Ave, Oklahoma City, OK 73117-1214 | 2008-08-06 |
| 1104084359 | Dennis Allan Leseberg | Dentist | 1008 Nw Grand Blvd, Suite A, Oklahoma City, OK 73118-6084 | 2008-05-23 |
| 1578721726 | David Brian Shadid | Dentist | 1201 N Stonewall Ave, Oklahoma City, OK 73117 | 2008-05-23 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73118 |
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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.